Healthcare Provider Details

I. General information

NPI: 1528894177
Provider Name (Legal Business Name): 1ST ROYAL CARE ASSISTED LIVING, INC.
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 09/10/2024
Last Update Date: 09/10/2024
Certification Date: 09/10/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

706 GLENWOOD AVE
BALTIMORE MD
21212-4234
US

IV. Provider business mailing address

706 GLENWOOD AVE
BALTIMORE MD
21212-4234
US

V. Phone/Fax

Practice location:
  • Phone: 301-237-4369
  • Fax:
Mailing address:
  • Phone: 301-237-4369
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code310400000X
TaxonomyAssisted Living Facility
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code3104A0625X
TaxonomyAssisted Living Facility (Mental Illness)
License Number
License Number State
# 3
Primary TaxonomyN
Taxonomy Code3104A0630X
TaxonomyAssisted Living Facility (Behavioral Disturbances)
License Number
License Number State

VIII. Authorized Official

Name: ANGELLA B JULIUS
Title or Position: MANAGING PARTNER
Credential:
Phone: 301-237-4369