Executive Residential Services LLC

Primary specialty

Assisted Living FacilityTaxonomy code 310400000X

Legal business name

EXECUTIVE RESIDENTIAL SERVICES LLC

Practice address

856 N West St
Anaheim, CA 92801-4302

Phone

(949) 258-3663

NPI assigned

Apr 24, 2026

Last updated

Apr 24, 2026By the provider in NPPES

Organization subpart

No

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name

Ms. Genesis Johnson

Title

Administrator

Phone

(562) 230-9589

Specialties & licenses 1

Addresses

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1776988800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1776988800000",
    "number": "1215873088",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "856 N WEST ST",
            "city": "ANAHEIM",
            "state": "CA",
            "postal_code": "928014302",
            "telephone_number": "949-258-3663"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "856 N WEST ST",
            "city": "ANAHEIM",
            "state": "CA",
            "postal_code": "928014302",
            "telephone_number": "949-258-3663"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "EXECUTIVE RESIDENTIAL SERVICES LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2026-04-24",
        "last_updated": "2026-04-24",
        "certification_date": "2026-04-24",
        "status": "A",
        "authorized_official_last_name": "JOHNSON",
        "authorized_official_first_name": "GENESIS",
        "authorized_official_title_or_position": "ADMINISTRATOR",
        "authorized_official_telephone_number": "562-230-9589",
        "authorized_official_name_prefix": "Ms."
    },
    "taxonomies": [
        {
            "code": "310400000X",
            "taxonomy_group": "",
            "desc": "Assisted Living Facility",
            "state": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• Assisted Living Facility in Anaheim, CA
• Providers in Anaheim, CA by specialty
• Assisted Living Facility in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 24, 2026; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.