Healthcare Provider Details

I. General information

NPI: 1053827238
Provider Name (Legal Business Name): ROYAL MINDS INC.
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 12/25/2017
Last Update Date: 12/25/2017
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

500 WOODBOURNE AVE
BALTIMORE MD
21212-4244
US

IV. Provider business mailing address

111 CHURCH ST
BALTIMORE MD
21225-3503
US

V. Phone/Fax

Practice location:
  • Phone: 240-486-1238
  • Fax: 240-486-1238
Mailing address:
  • Phone: 240-486-1238
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code104100000X
TaxonomySocial Worker
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code251B00000X
TaxonomyCase Management Agency
License Number
License Number State
# 3
Primary TaxonomyN
Taxonomy Code310400000X
TaxonomyAssisted Living Facility
License Number
License Number State

VIII. Authorized Official

Name: MR. AL MUFTAU ADEITE
Title or Position: PRESIDENT
Credential:
Phone: 240-486-1238