Provider Demographics
NPI:1861941965
Name:ROYAL HEALTH SENIOR CARE LLC
Entity type:Organization
Organization Name:ROYAL HEALTH SENIOR CARE LLC
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:ADMINISTRATOR
Authorized Official - Prefix:
Authorized Official - First Name:HABIBA
Authorized Official - Middle Name:
Authorized Official - Last Name:HARUN
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:612-245-3301
Mailing Address - Street 1:4920 NIAGARA RD
Mailing Address - Street 2:109
Mailing Address - City:COLLEGE PARK
Mailing Address - State:MD
Mailing Address - Zip Code:20740-1110
Mailing Address - Country:US
Mailing Address - Phone:612-245-3301
Mailing Address - Fax:240-652-8700
Practice Address - Street 1:4920 NIAGARA RD
Practice Address - Street 2:109
Practice Address - City:COLLEGE PARK
Practice Address - State:MD
Practice Address - Zip Code:20740-1110
Practice Address - Country:US
Practice Address - Phone:612-245-3301
Practice Address - Fax:240-652-8700
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:ROYAL HEALTH SENIOR CARE LLC
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2016-09-29
Last Update Date:2016-09-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MDR 3929251E00000X, 253Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes253Z00000XAgenciesIn Home Supportive Care
No251E00000XAgenciesHome Health