Provider Demographics
NPI:1417554221
Name:ROYALTY'S LOYALTY IN HOME LLC
Entity Type:Organization
Organization Name:ROYALTY'S LOYALTY IN HOME LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER/MANAGER
Authorized Official - Prefix:
Authorized Official - First Name:REVELYN
Authorized Official - Middle Name:
Authorized Official - Last Name:GUTHRIE
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:314-283-3394
Mailing Address - Street 1:2165 KINGSFORD DR
Mailing Address - Street 2:
Mailing Address - City:FLORISSANT
Mailing Address - State:MO
Mailing Address - Zip Code:63031-2734
Mailing Address - Country:US
Mailing Address - Phone:314-283-3394
Mailing Address - Fax:
Practice Address - Street 1:2165 KINGSFORD DR
Practice Address - Street 2:
Practice Address - City:FLORISSANT
Practice Address - State:MO
Practice Address - Zip Code:63031-2734
Practice Address - Country:US
Practice Address - Phone:314-283-3394
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2020-10-05
Last Update Date:2020-10-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251E00000XAgenciesHome Health
No385H00000XRespite Care FacilityRespite Care