Organization
EXCELSIOR COMMUNITY SERVICES, LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DEBORAH ANN MCKENZIE (OWNER/CEO)
(904) 559-5975
Entity
Organization
Contact information
Practice address
101 CENTURY 21 DR, STE 109B, JACKSONVILLE, FL 32216-8115
(904) 619-1972
Mailing address
101 CENTURY 21 DR, STE 109B, JACKSONVILLE, FL 32216-8115
(904) 619-1972
Taxonomy
Speciality
Code
Description
License number
State
251B00000X
Case Management Agency
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
016492600
—
FL
Enumeration date
12/08/2015
Last updated
11/15/2017
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