Organization
EXCEL COMMUNITY BEHAVIORAL HEALTH SERVICES, LLC
Active
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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