Provider Demographics
NPI:1083961023
Name:EXECUTIVE CHOICE HOME CARE SERVICES
Entity type:Organization
Organization Name:EXECUTIVE CHOICE HOME CARE SERVICES
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CEO/PRESIDENT
Authorized Official - Prefix:MR
Authorized Official - First Name:JOHN
Authorized Official - Middle Name:CHATMAN
Authorized Official - Last Name:CHATMAN
Authorized Official - Suffix:II
Authorized Official - Credentials:
Authorized Official - Phone:713-459-5480
Mailing Address - Street 1:6715 KEITHWOOD CIR S
Mailing Address - Street 2:
Mailing Address - City:PEARLAND
Mailing Address - State:TX
Mailing Address - Zip Code:77584-7151
Mailing Address - Country:US
Mailing Address - Phone:713-459-5480
Mailing Address - Fax:
Practice Address - Street 1:6715 KEITHWOOD CIR S
Practice Address - Street 2:
Practice Address - City:PEARLAND
Practice Address - State:TX
Practice Address - Zip Code:77584-7151
Practice Address - Country:US
Practice Address - Phone:713-459-5480
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2012-08-09
Last Update Date:2012-08-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes305S00000XManaged Care OrganizationsPoint of Service