Organization
EXCEL 4 LIFE, INC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MARIO JACKSON B.A CRIMINAL JUSTICE (OWNER/DIRECTOR)
(252) 205-0381
Entity
Organization
Contact information
Practice address
149 N MARKET ST, WASHINGTON, NC 27889-4947
(252) 946-4243
(252) 946-4243
Mailing address
149 N MARKET ST, WASHINGTON, NC 27889-4947
(252) 946-4243
(252) 946-4243
Taxonomy
Speciality
Code
Description
License number
State
251S00000X
Community/Behavioral Health Agency
Primary
—
—
Other
Enumeration date
08/31/2009
Last updated
08/31/2009
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