Provider Demographics
NPI:1811181514
Name:ROYALTY HOME HEALTH CARE SERVICES LLC
Entity type:Organization
Organization Name:ROYALTY HOME HEALTH CARE SERVICES LLC
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:MARDELL
Authorized Official - Middle Name:DIANE
Authorized Official - Last Name:BUTLER
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:303-360-7288
Mailing Address - Street 1:PO BOX 111086
Mailing Address - Street 2:
Mailing Address - City:AURORA
Mailing Address - State:CO
Mailing Address - Zip Code:80042-1086
Mailing Address - Country:US
Mailing Address - Phone:303-360-7288
Mailing Address - Fax:303-366-9912
Practice Address - Street 1:20 S HAVANA ST
Practice Address - Street 2:SUITE 210
Practice Address - City:AURORA
Practice Address - State:CO
Practice Address - Zip Code:80012-6445
Practice Address - Country:US
Practice Address - Phone:303-360-7288
Practice Address - Fax:303-366-9912
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-09-05
Last Update Date:2007-11-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251E00000XAgenciesHome Health
Provider Identifiers
StateIdentifier IDID TypeIssuer
CO63077213Medicaid