Provider Demographics
NPI:1952501884
Name:ROYAL HOME CARE AGENCY
Entity Type:Organization
Organization Name:ROYAL HOME CARE AGENCY
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PARNER AND ADMINISTRATOR
Authorized Official - Prefix:MR
Authorized Official - First Name:ABDULKADIR
Authorized Official - Middle Name:NUR
Authorized Official - Last Name:HAJI
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:507-363-9501
Mailing Address - Street 1:685 W BRIDGE ST STE 2
Mailing Address - Street 2:
Mailing Address - City:OWATONNA
Mailing Address - State:MN
Mailing Address - Zip Code:55060-2888
Mailing Address - Country:US
Mailing Address - Phone:507-363-9501
Mailing Address - Fax:
Practice Address - Street 1:685 W BRIDGE ST STE 2
Practice Address - Street 2:
Practice Address - City:OWATONNA
Practice Address - State:MN
Practice Address - Zip Code:55060-2888
Practice Address - Country:US
Practice Address - Phone:507-363-9501
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-07-19
Last Update Date:2007-07-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MNHE-01084-04251E00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251E00000XAgenciesHome Health