Provider Demographics
NPI: | 1932949260 |
---|---|
Name: | EXECUTIVE SERVICES, LLC |
Entity type: | Organization |
Organization Name: | EXECUTIVE SERVICES, LLC |
Other - Org Name: | |
Other - Org Type: | |
Authorized Official - Title/Position: | OWNER |
Authorized Official - Prefix: | DR |
Authorized Official - First Name: | NAVAID |
Authorized Official - Middle Name: | |
Authorized Official - Last Name: | SYED |
Authorized Official - Suffix: | |
Authorized Official - Credentials: | MD |
Authorized Official - Phone: | 409-276-8346 |
Mailing Address - Street 1: | 3916 N POTSDAM AVE # 5394 |
Mailing Address - Street 2: | |
Mailing Address - City: | SIOUX FALLS |
Mailing Address - State: | SD |
Mailing Address - Zip Code: | 57104-7048 |
Mailing Address - Country: | US |
Mailing Address - Phone: | 409-276-8346 |
Mailing Address - Fax: | |
Practice Address - Street 1: | 25 MAIN ST # 200 |
Practice Address - Street 2: | |
Practice Address - City: | WESTLAKE |
Practice Address - State: | OH |
Practice Address - Zip Code: | 44145-6975 |
Practice Address - Country: | US |
Practice Address - Phone: | 409-276-8346 |
Practice Address - Fax: | |
EIN: | <UNAVAIL> |
Is Organization Subpart?: | No |
Parent Organization LBN: | |
Parent Organization TIN: | |
Enumeration Date: | 2024-05-24 |
Last Update Date: | 2024-05-24 |
Deactivation Date: | |
Deactivation Code: | |
Reactivation Date: |
Provider Taxonomies
Primary? | Code | Type | Classification | Specialization | Group |
---|---|---|---|---|---|
Yes | 291U00000X | Laboratories | Clinical Medical Laboratory | Group - Multi-Specialty | |
No | 171400000X | Other Service Providers | Health & Wellness Coach | Group - Multi-Specialty | |
No | 174H00000X | Other Service Providers | Health Educator | Group - Multi-Specialty | |
No | 246Y00000X | Technologists, Technicians & Other Technical Service Providers | Specialist/Technologist, Health Information | Group - Multi-Specialty | |
No | 247000000X | Technologists, Technicians & Other Technical Service Providers | Technician, Health Information | Group - Multi-Specialty | |
No | 247200000X | Technologists, Technicians & Other Technical Service Providers | Technician, Other | Group - Multi-Specialty | |
No | 247ZC0005X | Technologists, Technicians & Other Technical Service Providers | Technician, Pathology | Clinical Laboratory Director, Non-physician | Group - Multi-Specialty |
No | 251E00000X | Agencies | Home Health | ||
No | 251V00000X | Agencies | Voluntary or Charitable | ||
No | 261Q00000X | Ambulatory Health Care Facilities | Clinic/Center | ||
No | 261QA0600X | Ambulatory Health Care Facilities | Clinic/Center | Adult Day Care | |
No | 261QH0100X | Ambulatory Health Care Facilities | Clinic/Center | Health Service | |
No | 343900000X | Transportation Services | Non-emergency Medical Transport (VAN) | ||
No | 372500000X | Nursing Service Related Providers | Chore Provider | Group - Multi-Specialty | |
No | 372600000X | Nursing Service Related Providers | Adult Companion | Group - Multi-Specialty |