Healthcare Provider Details

I. General information

NPI: 1093659914
Provider Name (Legal Business Name): OPAL ROYAL HOME CARE INC.
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 04/20/2026
Last Update Date: 04/20/2026
Certification Date: 04/20/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3511 REISTERSTOWN RD
BALTIMORE MD
21215-7718
US

IV. Provider business mailing address

3511 REISTERSTOWN RD
BALTIMORE MD
21215-7718
US

V. Phone/Fax

Practice location:
  • Phone: 832-610-8914
  • Fax: 248-864-8042
Mailing address:
  • Phone: 832-610-8914
  • Fax: 248-864-8042

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code376J00000X
TaxonomyHomemaker
License Number
License Number State

VIII. Authorized Official

Name: CHIOMA NNENAYA UKWA
Title or Position: ADMINISTRATOR
Credential:
Phone: 780-787-8778