Provider Demographics
NPI:1285168211
Name:ROYAL HOME CARE SERVICES, LLC
Entity type:Organization
Organization Name:ROYAL HOME CARE SERVICES, LLC
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:CO-OWNER
Authorized Official - Prefix:MRS
Authorized Official - First Name:BRITTANY
Authorized Official - Middle Name:NICHOLE
Authorized Official - Last Name:ALSHAWY
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:719-338-3001
Mailing Address - Street 1:6612 COTTONWOOD GROVE DR
Mailing Address - Street 2:
Mailing Address - City:COLORADO SPRINGS
Mailing Address - State:CO
Mailing Address - Zip Code:80925-1302
Mailing Address - Country:US
Mailing Address - Phone:719-663-0033
Mailing Address - Fax:719-888-1280
Practice Address - Street 1:5150 N UNION BLVD STE 200A
Practice Address - Street 2:
Practice Address - City:COLORADO SPRINGS
Practice Address - State:CO
Practice Address - Zip Code:80918-2075
Practice Address - Country:US
Practice Address - Phone:719-663-0033
Practice Address - Fax:719-888-1280
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2017-04-17
Last Update Date:2022-09-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CO251E00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251E00000XAgenciesHome Health
Provider Identifiers
StateIdentifier IDID TypeIssuer
CO1285168211Medicaid