Provider Demographics
NPI:1578332920
Name:ROYAL HOUSING LLC
Entity Type:Organization
Organization Name:ROYAL HOUSING LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:KHADRO
Authorized Official - Middle Name:A
Authorized Official - Last Name:YUSUF
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:612-300-4001
Mailing Address - Street 1:1750 130TH AVE NE
Mailing Address - Street 2:
Mailing Address - City:BLAINE
Mailing Address - State:MN
Mailing Address - Zip Code:55449-4905
Mailing Address - Country:US
Mailing Address - Phone:612-300-4001
Mailing Address - Fax:
Practice Address - Street 1:1750 130TH AVE NE
Practice Address - Street 2:
Practice Address - City:BLAINE
Practice Address - State:MN
Practice Address - Zip Code:55449-4905
Practice Address - Country:US
Practice Address - Phone:612-300-4001
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2023-12-27
Last Update Date:2023-12-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes374U00000XNursing Service Related ProvidersHome Health Aide