Healthcare Provider Details

I. General information

NPI: 1326289182
Provider Name (Legal Business Name): ROYAL HOMES
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 03/08/2009
Last Update Date: 03/08/2009
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

6210 N CAPITOL ST NW
WASHINGTON DC
20011-1416
US

IV. Provider business mailing address

11913 NEW COUNTRY LN
COLUMBIA MD
21044-4404
US

V. Phone/Fax

Practice location:
  • Phone: 443-414-6893
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code311ZA0620X
TaxonomyAdult Care Home Facility
License Number
License Number State

VIII. Authorized Official

Name: ALFRED EZEKWESILI
Title or Position: PRESIDENT
Credential:
Phone: 443-414-6893