Healthcare Provider Details

I. General information

NPI: 1912720285
Provider Name (Legal Business Name): ROYAL HOME LIVING LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 11/05/2024
Last Update Date: 11/05/2024
Certification Date: 11/05/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3695 E DOGWOOD DR
CHANDLER AZ
85286-0128
US

IV. Provider business mailing address

3695 E DOGWOOD DR
CHANDLER AZ
85286-0128
US

V. Phone/Fax

Practice location:
  • Phone: 623-287-5186
  • Fax:
Mailing address:
  • Phone: 623-287-5186
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code372500000X
TaxonomyChore Provider
License Number
License Number StateNULL
# 2
Primary TaxonomyN
Taxonomy Code372600000X
TaxonomyAdult Companion
License Number
License Number StateNULL
# 3
Primary TaxonomyN
Taxonomy Code3747P1801X
TaxonomyPersonal Care Attendant
License Number
License Number StateNULL
# 4
Primary TaxonomyN
Taxonomy Code376J00000X
TaxonomyHomemaker
License Number
License Number StateNULL
# 5
Primary TaxonomyN
Taxonomy Code253Z00000X
TaxonomyIn Home Supportive Care Agency
License Number
License Number StateNULL
# 6
Primary TaxonomyY
Taxonomy Code171M00000X
TaxonomyCase Manager/Care Coordinator
License Number
License Number StateNULL

VIII. Authorized Official

Name: NAJAH WASHINGTON
Title or Position: PRESIDENT/COORDINATOR
Credential:
Phone: 623-287-5186