Healthcare Provider Details

I. General information

NPI: 1578507224
Provider Name (Legal Business Name): ROYAL INC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 06/15/2006
Last Update Date: 08/22/2020
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

7119 HWY 1 SOUTH
MARKSVILLE LA
71351
US

IV. Provider business mailing address

PO BOX 629
MARKSVILLE LA
71351-0629
US

V. Phone/Fax

Practice location:
  • Phone: 318-253-6553
  • Fax: 318-253-4946
Mailing address:
  • Phone: 318-253-6553
  • Fax: 318-253-4946

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code314000000X
TaxonomySkilled Nursing Facility
License Number351
License Number StateLA

VIII. Authorized Official

Name: JEFFREY CAUBARREAUX
Title or Position: ADMINISTRATOR
Credential:
Phone: 318-253-6553