Healthcare Provider Details

I. General information

NPI: 1770407934
Provider Name (Legal Business Name): LAVISH ROYALTY HOME CARE MI LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 08/08/2026
Last Update Date: 08/08/2026
Certification Date: 08/08/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

405 W GREENLAWN AVE STE G11
LANSING MI
48910-2889
US

IV. Provider business mailing address

405 W GREENLAWN AVE STE G11
LANSING MI
48910-2889
US

V. Phone/Fax

Practice location:
  • Phone: 574-971-1610
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code253Z00000X
TaxonomyIn Home Supportive Care Agency
License Number
License Number State

VIII. Authorized Official

Name: KAEISHA MURDOCK
Title or Position: CEO
Credential:
Phone: 574-971-1610