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General NPI Number Information
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NPI Number | 1952501884
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Entity Type | Organization
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Legal Business Name | ROYAL HOME CARE AGENCY
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Dates
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Enumeration Date | 07/19/2007
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Last Update Date | 07/19/2007
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Provider Practice Location Address
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Address Line | 685 W BRIDGE ST STE 2
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City | OWATONNA
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State | MN
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Zip | 55060-2888
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Country | US
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Telephone | 507-363-9501
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Fax |
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Provider Business Mailing Address
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Address Line | 685 W BRIDGE ST STE 2
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City | OWATONNA
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State | MN
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Zip | 55060-2888
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Country | US
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Telephone | 507-363-9501
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Fax |
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Authorized Official
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Title or Position | PARNER AND ADMINISTRATOR
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Name | MR. ABDULKADIR NUR HAJI
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Credential |
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Telephone | 507-363-9501
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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 | HE-01084-04
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License Number State | MN
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