Provider Demographics
NPI:1568942100
Name:ROYAL HOME COMPANION
Entity Type:Organization
Organization Name:ROYAL HOME COMPANION
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:KATE
Authorized Official - Middle Name:CHRISTINE
Authorized Official - Last Name:MOHAJERI
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:904-509-6167
Mailing Address - Street 1:822 A1A N STE 310
Mailing Address - Street 2:
Mailing Address - City:PONTE VEDRA BEACH
Mailing Address - State:FL
Mailing Address - Zip Code:32082-8209
Mailing Address - Country:US
Mailing Address - Phone:888-258-5129
Mailing Address - Fax:
Practice Address - Street 1:822 A1A N STE 310
Practice Address - Street 2:
Practice Address - City:PONTE VEDRA BEACH
Practice Address - State:FL
Practice Address - Zip Code:32082-8209
Practice Address - Country:US
Practice Address - Phone:888-258-5129
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2018-08-14
Last Update Date:2018-08-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251E00000XAgenciesHome Health