MEDICARE: ROYALTY HEARTS

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	320900000X	Intellectual and/or Developmental Disabilities Community Based Residential Treatment Facility

General Provider Information

NPI Number	:	1336017920
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	ROYALTY HEARTS

Provider Business Mailing Address
First Line	:	1958 W 47TH ST
Second Line	:
City	:	CLEVELAND
State	:	OH
Zip	:	44102-3435
Country	:	US
Telephone Number	:	216-471-7363
Fax Number	:

Provider Business Practice Location Address
First Line	:	1958 W 47TH ST
Second Line	:
City	:	CLEVELAND
State	:	OH
Zip	:	44102-3435
Country	:	US
Telephone Number	:	216-471-7363
Fax Number	:

Authorized Official
Title or Position	:	OWNER
Name	:	MS. KAWANNA SHANTA ROYAL
Credential	:
Telephone Number	:	216-471-7363

Provider Enumeration Date	:	10/27/2025
Last Update Date	:	10/27/2025

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Directions to “ROYALTY HEARTS ” Practice Location

Language	Start Address	Practice Location

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