Provider Demographics
NPI:1659807725
Name:ROYAL HEARTS NURSING IN-HOME CARE
Entity Type:Organization
Organization Name:ROYAL HEARTS NURSING IN-HOME CARE
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:SHELISA
Authorized Official - Middle Name:K
Authorized Official - Last Name:TURNER
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:916-889-4837
Mailing Address - Street 1:104 N SCHOOL ST
Mailing Address - Street 2:SUITE NUMBER 206
Mailing Address - City:LODI
Mailing Address - State:CA
Mailing Address - Zip Code:95240-2148
Mailing Address - Country:US
Mailing Address - Phone:209-400-7734
Mailing Address - Fax:209-400-7737
Practice Address - Street 1:104 N SCHOOL ST
Practice Address - Street 2:SUITE NUMBER 206
Practice Address - City:LODI
Practice Address - State:CA
Practice Address - Zip Code:95240
Practice Address - Country:US
Practice Address - Phone:209-400-7734
Practice Address - Fax:209-400-7737
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2017-05-10
Last Update Date:2017-05-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA1516251E00000X, 251F00000X, 251G00000X, 251J00000X, 251T00000X, 253Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251J00000XAgenciesNursing Care
No251E00000XAgenciesHome Health
No251F00000XAgenciesHome Infusion
No251G00000XAgenciesHospice Care, Community Based
No251T00000XAgenciesProgram of All-Inclusive Care for the Elderly (PACE) Provider Organization
No253Z00000XAgenciesIn Home Supportive Care