Organization
EXCEL RESIDENTIAL HOME
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MR. KENNETH WATTS ADMINISTRATOR (ADMINISTRATOR)
(213) 369-1383
Entity
Organization
Contact information
Practice address
5503 S MANHATTAN PL, LOS ANGELES, CA 90062-2622
(213) 369-1383
Mailing address
5503 S MANHATTAN PL, LOS ANGELES, CA 90062-2622
(213) 369-1383
Taxonomy
Speciality
Code
Description
License number
State
310400000X
Assisted Living Facility
Primary
—
—
3104A0625X
Assisted Living Facility (Mental Illness)
—
—
Other
Enumeration date
07/15/2024
Last updated
07/15/2024
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