Healthcare Provider Details

I. General information

NPI: 1235929894
Provider Name (Legal Business Name): ROYALTY HOMECARE SERVICES LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 05/07/2025
Last Update Date: 05/07/2025
Certification Date: 05/07/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

7900 INTERNATIONAL DR
BLOOMINGTON MN
55425-1510
US

IV. Provider business mailing address

7900 INTERNATIONAL DR STE 300
BLOOMINGTON MN
55425-2562
US

V. Phone/Fax

Practice location:
  • Phone: 952-456-0054
  • Fax:
Mailing address:
  • Phone: 952-456-0054
  • 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 Code251G00000X
TaxonomyCommunity Based Hospice Care Agency
License Number
License Number State
# 3
Primary TaxonomyN
Taxonomy Code251J00000X
TaxonomyNursing Care Agency
License Number
License Number State
# 4
Primary TaxonomyN
Taxonomy Code315D00000X
TaxonomyInpatient Hospice
License Number
License Number State

VIII. Authorized Official

Name: IISHA LAKEYIA JONES
Title or Position: OWNER
Credential: LPN
Phone: 763-245-9359