Healthcare Provider Details

I. General information

NPI: 1447186184
Provider Name (Legal Business Name): COVENTRY ROYAL CARE LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 06/22/2026
Last Update Date: 06/22/2026
Certification Date: 06/21/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

17717 N 69TH AVE
GLENDALE AZ
85308-8448
US

IV. Provider business mailing address

17717 N 69TH AVE
GLENDALE AZ
85308-8448
US

V. Phone/Fax

Practice location:
  • Phone: 602-900-6868
  • Fax: 480-877-9864
Mailing address:
  • Phone: 602-900-6868
  • Fax: 480-877-9864

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code310400000X
TaxonomyAssisted Living Facility
License Number
License Number State

VIII. Authorized Official

Name: STEFAN STRIBLEA
Title or Position: OWNER
Credential:
Phone: 602-900-6868