Healthcare Provider Details

I. General information

NPI: 1144168501
Provider Name (Legal Business Name): ROYAL HAVENS LLC DBA ROYAL HAVENS HOME HEALTH
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 03/24/2026
Last Update Date: 03/24/2026
Certification Date: 03/24/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

34814 17TH CT SW
FEDERAL WAY WA
98023-3109
US

IV. Provider business mailing address

34814 17TH CT SW
FEDERAL WAY WA
98023-3109
US

V. Phone/Fax

Practice location:
  • Phone: 313-828-4162
  • Fax:
Mailing address:
  • Phone: 313-828-4162
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code251E00000X
TaxonomyHome Health Agency
License Number
License Number State

VIII. Authorized Official

Name: JANE WANGECHI MAINA
Title or Position: MANAGING OWNER
Credential: JANE WANGECHI
Phone: 313-828-4162