Healthcare Provider Details
I. General information
NPI: 1154872992
Provider Name (Legal Business Name): ROYALTY HOME CARE AGENCY,INC
Entity Type: Organization
Gender:
Sole Proprietor:
II. Dates (important events)
Enumeration Date: 10/17/2016
Last Update Date: 10/28/2019
Certification Date:
Deactivation Date:
Reactivation Date:
III. Provider practice location address
4787 LAKE ARJARO DR
WEST PALM BEACH FL
33407-1762
US
IV. Provider business mailing address
PO BOX 222742
WEST PALM BEACH FL
33422-2742
US
V. Phone/Fax
- Phone: 561-436-8725
- Fax: 561-623-7866
- Phone: 561-436-8725
- Fax:
VI. Provider taxonomy
Scope of Practice (Provider specialty)
| # 1 | |
| Primary Taxonomy | Y |
| Taxonomy Code | 251E00000X |
| Taxonomy | Home Health Agency |
| License Number | |
| License Number State | |
| # 2 | |
| Primary Taxonomy | N |
| Taxonomy Code | 251G00000X |
| Taxonomy | Community Based Hospice Care Agency |
| License Number | |
| License Number State | |
| # 3 | |
| Primary Taxonomy | N |
| Taxonomy Code | 253Z00000X |
| Taxonomy | In Home Supportive Care Agency |
| License Number | |
| License Number State | |
| # 4 | |
| Primary Taxonomy | N |
| Taxonomy Code | 376J00000X |
| Taxonomy | Homemaker |
| License Number | |
| License Number State | |
VIII. Authorized Official
Name:
HATTIE
MARIE
ROBERSON
Title or Position: PRESIDENT
Credential:
Phone: 561-436-8725