Healthcare Provider Details

I. General information

NPI: 1679244834
Provider Name (Legal Business Name): OPAL ROYAL HOME CARE INC.
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 09/27/2021
Last Update Date: 04/28/2026
Certification Date: 04/28/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

23800 W 10 MILE RD STE 260
SOUTHFIELD MI
48033-3199
US

IV. Provider business mailing address

23800 W 10 MILE RD STE 260
SOUTHFIELD MI
48033-3199
US

V. Phone/Fax

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

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code251E00000X
TaxonomyHome Health Agency
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code261QA0600X
TaxonomyAdult Day Care Clinic/Center
License Number
License Number State

VIII. Authorized Official

Name: CHIOMA UKWA
Title or Position: PRESIDENT
Credential:
Phone: 832-610-8914