Healthcare Provider Details

I. General information

NPI: 1710545652
Provider Name (Legal Business Name): ROYAL FAMILY SERVICES LLC DBA ROYAL ADULT DAY CENTER
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 06/05/2019
Last Update Date: 01/15/2022
Certification Date: 01/15/2022
Deactivation Date:
Reactivation Date:

III. Provider practice location address

11138 OLD SAINT CHARLES RD
SAINT ANN MO
63074-2113
US

IV. Provider business mailing address

11138 OLD SAINT CHARLES RD
SAINT ANN MO
63074-2113
US

V. Phone/Fax

Practice location:
  • Phone: 314-755-1065
  • Fax:
Mailing address:
  • Phone: 314-755-1065
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code261QA0600X
TaxonomyAdult Day Care Clinic/Center
License Number
License Number State

VIII. Authorized Official

Name: CHARLNISHIA WILKINS
Title or Position: OWNER
Credential:
Phone: 314-755-1065