Provider Demographics
NPI:1447910872
Name:ROYALTY ANGELS LLC
Entity type:Organization
Organization Name:ROYALTY ANGELS LLC
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:OWNER/OPERATOR
Authorized Official - Prefix:
Authorized Official - First Name:PATRICHA
Authorized Official - Middle Name:A
Authorized Official - Last Name:JEAN
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:586-552-4300
Mailing Address - Street 1:22811 GREATER MACK AVE STE 112
Mailing Address - Street 2:
Mailing Address - City:SAINT CLAIR SHORES
Mailing Address - State:MI
Mailing Address - Zip Code:48080-2053
Mailing Address - Country:US
Mailing Address - Phone:586-552-4300
Mailing Address - Fax:586-552-4304
Practice Address - Street 1:22811 GREATER MACK AVE STE 112
Practice Address - Street 2:
Practice Address - City:SAINT CLAIR SHORES
Practice Address - State:MI
Practice Address - Zip Code:48080-2053
Practice Address - Country:US
Practice Address - Phone:586-552-4300
Practice Address - Fax:586-552-4300
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2021-12-27
Last Update Date:2023-09-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes253Z00000XAgenciesIn Home Supportive Care
No251E00000XAgenciesHome Health