Organization
EXCEL COMMUNITY BEHAVIORAL HEALTH SERVICES, LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
KIMERLYN JOHNSON EDS (OPERATIONS ADMINSTRATOR)
(813) 422-5502
Entity
Organization
Contact information
Practice address
9780 N 56TH ST STE B, TEMPLE TERRACE, FL 33617-5508
(813) 422-5502
(813) 364-6474
Mailing address
5450 BRUCE B DOWNS BLVD STE 328, WESLEY CHAPEL, FL 33544-8616
(813) 422-5502
(813) 364-6474
Taxonomy
Speciality
Code
Description
License number
State
101YM0800X
Mental Health Counselor
—
—
103TB0200X
Cognitive & Behavioral Psychologist
—
—
251S00000X
Community/Behavioral Health Agency
Primary
—
—
Other
Enumeration date
05/29/2019
Last updated
04/22/2020
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