MEDICARE: ROYAL PERSONAL HEALTHCARE NETWORK INC

Medicare Provider Information

Scope of Practice

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

#	Taxonomy Code	Taxonomy
1	320900000X	Intellectual and/or Developmental Disabilities Community Based Residential Treatment Facility
2	385HR2060X	Child Intellectual and/or Developmental Disabilities Respite Care
3	251B00000X	Case Management Agency

General Provider Information

NPI Number	:	1699102574
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	ROYAL PERSONAL HEALTHCARE NETWORK INC

Provider Business Mailing Address
First Line	:	8919 ASPEN MEADOW DR
Second Line	:
City	:	HOUSTON
State	:	TX
Zip	:	77071-3256
Country	:	US
Telephone Number	:	713-907-5717
Fax Number	:

Provider Business Practice Location Address
First Line	:	8919 ASPEN MEADOW DR
Second Line	:
City	:	HOUSTON
State	:	TX
Zip	:	77071-3256
Country	:	US
Telephone Number	:	713-907-5717
Fax Number	:

Authorized Official
Title or Position	:	CEO
Name	:	IFEOMA FIDEL DIKE
Credential	:
Telephone Number	:	713-907-5717

Provider Enumeration Date	:	10/08/2013
Last Update Date	:	10/08/2013

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