Excelsior Grace Llc

LBN: Excelsior Grace Llc
Excelsior Grace Llc is an health care organization with primary practice located at 959 W 4Th St , Plainfield NJ 07063-1372. The organization recently has only one registered license in Physician Assistants & Advanced Practice Nursing Providers / Psychiatric/Mental Health, which is considered as the primary health care specialty. Excelsior Grace Llc can be contacted via phone (347) 302-1212, or through Omotayo, Oluwabunmi via phone (347) 302-1212.

Contact Information

Primary practice address
959 W 4Th St Plainfield NJ 07063-1372
Phone: (347) 302-1212
Fax:
Website:
Map and Directions
Authorized official contact:
Name: Omotayo, Oluwabunmi Advanced Practice Nurse (APN)
Phone: (347) 302-1212

Health care specialties

SpecialtyCodeLicense #State
Physician Assistants & Advanced Practice Nursing Providers / Psychiatric/Mental Health 363LP0808X

Profile Details

NPI number 1649149238
LBN Legal business name Excelsior Grace Llc
DBA Doing business as
Authorized official Omotayo, Oluwabunmi Advanced Practice Nurse (APN)
Entity Organization
Organization subpart 1 No
Enumeration date Nov 1st, 2025
Last updated Nov 4th, 2025 - about last year

1 Some organizations, which are providing health care services, may consist of units or departments that provide different types of health care services or have several separate physical locations, where health care service is provided. These units, departments or physical locations are not themselves legal entities. However, each of them is part of the organization, which is a legal entity. The organization may decide whether its subparts, if it has any, should have their own NPI numbers. In case a subpart conducts any HIPAA standard transactions by itself, without its parent's involvement, it must have its own NPI number.

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