Royal Star Residence, Inc.

Primary specialty

Nursing Care AgencyTaxonomy code 251J00000X

Legal business name

ROYAL STAR RESIDENCE, INC.

Practice address

5701 Shingle Creek Pkwy N
Suite 500Q
Brooklyn Center, MN 55430-2386

Phone

(763) 442-5136

NPI assigned

Aug 21, 2018

Last updated

Dec 9, 2019By the provider in NPPES

Organization subpart

No

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name

Mr. Christian Kanmue Kolleh

Title

Executive Director

Phone

(763) 442-5136

Specialties & licenses 1

Addresses

Locations

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1534809600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1575849600000",
    "number": "1407336118",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5701 SHINGLE CREEK PKWY N",
            "address_2": "SUITE 500Q",
            "city": "BROOKLYN CENTER",
            "state": "MN",
            "postal_code": "554302386",
            "telephone_number": "763-442-5136"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5701 SHINGLE CREEK PKWY N",
            "address_2": "SUITE 500Q",
            "city": "BROOKLYN CENTER",
            "state": "MN",
            "postal_code": "554302386",
            "telephone_number": "763-442-5136"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "ROYAL STAR RESIDENCE, INC.",
        "organizational_subpart": "NO",
        "enumeration_date": "2018-08-21",
        "last_updated": "2019-12-09",
        "certification_date": "2019-12-09",
        "status": "A",
        "authorized_official_last_name": "KOLLEH",
        "authorized_official_first_name": "CHRISTIAN",
        "authorized_official_middle_name": "KANMUE",
        "authorized_official_title_or_position": "EXECUTIVE DIRECTOR",
        "authorized_official_telephone_number": "763-442-5136",
        "authorized_official_name_prefix": "Mr."
    },
    "taxonomies": [
        {
            "code": "251J00000X",
            "taxonomy_group": "",
            "desc": "Nursing Care",
            "state": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Adrianna May Rowe
• Royal Caringhands Home Healthcare Services
• Royal Healthcare Inc.
• Royal Home Care Inc
• Royal Home Care Inc
• Royals Personalize Care Services LLC
• Royals Personalized Transportation Services
• Colleen Kay Rusch, CNM
• Jill Marie Russell, LICSW
• Andrew A Rzepka

• Nursing Care Agency in Brooklyn Center, MN
• Providers in Brooklyn Center, MN by specialty
• Nursing Care Agency in Minnesota

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 9, 2019; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.