Provider Demographics
NPI:1538736095
Name:ROYAL HEALTHCARE LLC
Entity type:Organization
Organization Name:ROYAL HEALTHCARE LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:LICENSED CAREGIVER
Authorized Official - Prefix:
Authorized Official - First Name:MONAE
Authorized Official - Middle Name:SHEREE
Authorized Official - Last Name:ELLIS
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:262-424-1841
Mailing Address - Street 1:4030 N 44TH ST
Mailing Address - Street 2:
Mailing Address - City:MILWAUKEE
Mailing Address - State:WI
Mailing Address - Zip Code:53216-1502
Mailing Address - Country:US
Mailing Address - Phone:414-430-3217
Mailing Address - Fax:
Practice Address - Street 1:4030 N 44TH ST
Practice Address - Street 2:
Practice Address - City:MILWAUKEE
Practice Address - State:WI
Practice Address - Zip Code:53216-1502
Practice Address - Country:US
Practice Address - Phone:414-430-3217
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2021-06-04
Last Update Date:2021-06-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes374U00000XNursing Service Related ProvidersHome Health AideGroup - Multi-Specialty