Organization
EXECUTIVE RESIDENTIAL SERVICES LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MS. GENESIS JOHNSON (ADMINISTRATOR)
(562) 230-9589
Entity
Organization
Contact information
Practice address
856 N WEST ST, ANAHEIM, CA 92801-4302
(949) 258-3663
Mailing address
856 N WEST ST, ANAHEIM, CA 92801-4302
(949) 258-3663
Taxonomy
Speciality
Code
Description
License number
State
310400000X
Assisted Living Facility
Primary
—
—
Other
Enumeration date
04/24/2026
Last updated
04/24/2026
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