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General NPI Number Information
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NPI Number | 1659807725
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Entity Type | Organization
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Legal Business Name | ROYAL HEARTS NURSING IN-HOME CARE
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Dates
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Enumeration Date | 05/10/2017
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Last Update Date | 05/10/2017
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Provider Practice Location Address
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Address Line | 104 N SCHOOL ST SUITE NUMBER 206
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City | LODI
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State | CA
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Zip | 95240
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Country | US
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Telephone | 209-400-7734
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Fax | 209-400-7737
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Provider Business Mailing Address
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Address Line | 104 N SCHOOL ST SUITE NUMBER 206
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City | LODI
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State | CA
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Zip | 95240-2148
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Country | US
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Telephone | 209-400-7734
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Fax | 209-400-7737
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Authorized Official
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Title or Position | OWNER
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Name | SHELISA K TURNER
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Credential |
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Telephone | 916-889-4837
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 251E00000X
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Taxonomy Name | Home Health Agency
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License Number | 1516
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License Number State | CA
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Taxonomy #2
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Taxonomy Code | 251F00000X
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Taxonomy Name | Home Infusion Agency
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License Number | 1516
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License Number State | CA
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Taxonomy #3
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Taxonomy Code | 251G00000X
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Taxonomy Name | Community Based Hospice Care Agency
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License Number | 1516
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License Number State | CA
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Taxonomy #4
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Taxonomy Code | 251T00000X
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Taxonomy Name | PACE Provider Organization
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License Number | 1516
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License Number State | CA
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Taxonomy #5
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Taxonomy Code | 253Z00000X
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Taxonomy Name | In Home Supportive Care Agency
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License Number | 1516
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License Number State | CA
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Taxonomy #6
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Taxonomy Code | 251J00000X
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Taxonomy Name | Nursing Care Agency
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License Number | 1516
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License Number State | CA
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