Provider Demographics
NPI:1225845803
Name:EXECUTIVE HOME SERIVCES, INC.
Entity type:Organization
Organization Name:EXECUTIVE HOME SERIVCES, INC.
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:CHRISTOPHER
Authorized Official - Middle Name:TODD
Authorized Official - Last Name:SLACK
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:571-276-1978
Mailing Address - Street 1:894 MACCLESFIELD RD
Mailing Address - Street 2:
Mailing Address - City:FURLONG
Mailing Address - State:PA
Mailing Address - Zip Code:18925-1411
Mailing Address - Country:US
Mailing Address - Phone:571-276-1978
Mailing Address - Fax:
Practice Address - Street 1:894 MACCLESFIELD RD
Practice Address - Street 2:
Practice Address - City:FURLONG
Practice Address - State:PA
Practice Address - Zip Code:18925-1411
Practice Address - Country:US
Practice Address - Phone:571-276-1978
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2024-12-16
Last Update Date:2025-02-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes253Z00000XAgenciesIn Home Supportive Care
No251E00000XAgenciesHome Health
No251G00000XAgenciesHospice Care, Community Based