Healthcare Provider Details

I. General information

NPI: 1174353791
Provider Name (Legal Business Name): XCLUSIVE CARE SERVICES,LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 08/07/2024
Last Update Date: 03/18/2026
Certification Date: 03/18/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

105 ALLSPICE DR
COVINGTON GA
30016-1902
US

IV. Provider business mailing address

105 ALLSPICE DR
COVINGTON GA
30016-1902
US

V. Phone/Fax

Practice location:
  • Phone: 470-945-2141
  • Fax:
Mailing address:
  • Phone: 470-945-2141
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code251J00000X
TaxonomyNursing Care Agency
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code251E00000X
TaxonomyHome Health Agency
License Number
License Number State
# 3
Primary TaxonomyY
Taxonomy Code253Z00000X
TaxonomyIn Home Supportive Care Agency
License Number
License Number State

VIII. Authorized Official

Name: NIESHA S BARNETT
Title or Position: RN
Credential:
Phone: 301-250-6458