Organization
LA EXCELCARE
Active
Parent organization
LA EXCEL CARE INC
Other names
La ExcelCare
Organization subpart
Yes
Provider details
NPI number
Legal business name
LA EXCEL CARE INC
Authorized official
MR. DICKSON IDUSUYI (CEO)
(225) 361-0219
Entity
Organization
Contact information
Practice address
4348 S JEFFREY DR STE 102, BATON ROUGE, LA 70816-4196
(225) 361-0219
Mailing address
4348 S JEFFREY DR STE 102, BATON ROUGE, LA 70816-4196
(225) 361-0219
Taxonomy
Speciality
Code
Description
License number
State
251B00000X
Case Management Agency
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
601016816
—
LA
Enumeration date
08/10/2020
Last updated
08/10/2020
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