Organization
EXECUTIVE HOME CARE SERVICES, LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
SHAWAN DANIELS CNA (ADMINISTRATOR)
(470) 306-8260
Entity
Organization
Contact information
Practice address
3690 BASSWOOD RD, SNELLVILLE, GA 30039-4063
(470) 306-8226
Mailing address
3690 BASSWOOD RD, SNELLVILLE, GA 30039-4063
(470) 306-8226
Taxonomy
Speciality
Code
Description
License number
State
251G00000X
Community Based Hospice Care Agency
—
—
253Z00000X
In Home Supportive Care Agency
Primary
—
—
385H00000X
Respite Care
—
—
385HR2055X
Child Mental Illness Respite Care
—
—
385HR2060X
Child Intellectual and/or Developmental Disabilities Respite Care
—
—
Other
Enumeration date
03/25/2021
Last updated
03/25/2021
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