Provider Demographics
NPI:1841420114
Name:ROYALQUEEN HOMECARE, INC
Entity Type:Organization
Organization Name:ROYALQUEEN HOMECARE, INC
Other - Org Name:ROYALQUEEN HOMECARE, INC
Other - Org Type:Doing Business As
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:KOU
Authorized Official - Middle Name:TOU
Authorized Official - Last Name:XIONG
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:763-300-4615
Mailing Address - Street 1:7732 HAMPSHIRE AVE N
Mailing Address - Street 2:
Mailing Address - City:BROOKLYN PARK
Mailing Address - State:MN
Mailing Address - Zip Code:55445-2707
Mailing Address - Country:US
Mailing Address - Phone:763-300-4615
Mailing Address - Fax:763-560-1850
Practice Address - Street 1:7732 HAMPSHIRE AVE N
Practice Address - Street 2:
Practice Address - City:BROOKLYN PARK
Practice Address - State:MN
Practice Address - Zip Code:55445-2707
Practice Address - Country:US
Practice Address - Phone:763-300-4615
Practice Address - Fax:763-560-1850
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2009-07-21
Last Update Date:2009-07-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251E00000XAgenciesHome Health
No302F00000XManaged Care OrganizationsExclusive Provider Organization