Healthcare Provider Details

I. General information

NPI: 1902554355
Provider Name (Legal Business Name): ROYAL HEALTH CARE SERVICES
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 03/15/2022
Last Update Date: 03/27/2025
Certification Date: 03/27/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

230 E. NEW YORK AVENUE
DELAND FL
32724-5522
US

IV. Provider business mailing address

230 E. NEW YORK AVE
DELAND FL
32724-5522
US

V. Phone/Fax

Practice location:
  • Phone: 386-456-3224
  • Fax: 386-774-1203
Mailing address:
  • Phone: 386-624-6933
  • Fax: 386-774-1203

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code251B00000X
TaxonomyCase Management Agency
License Number
License Number State
# 2
Primary TaxonomyY
Taxonomy Code251S00000X
TaxonomyCommunity/Behavioral Health Agency
License Number
License Number State

VIII. Authorized Official

Name: MS. SUSAN KIMERIA
Title or Position: ADMINISTRATOR
Credential: FOUNDER
Phone: 407-535-8148