Healthcare Provider Details

I. General information

NPI: 1336617356
Provider Name (Legal Business Name): ROYAL CHILD ACADEMY COMPANY
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 11/07/2018
Last Update Date: 02/26/2022
Certification Date: 02/26/2022
Deactivation Date:
Reactivation Date:

III. Provider practice location address

6625 SULLINS RD
CHARLOTTE NC
28214-4102
US

IV. Provider business mailing address

11000 HUNTINGTON MEADOW LN
CHARLOTTE NC
28273-3440
US

V. Phone/Fax

Practice location:
  • Phone: 704-606-9243
  • Fax:
Mailing address:
  • Phone: 704-606-9243
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code251S00000X
TaxonomyCommunity/Behavioral Health Agency
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code320800000X
TaxonomyMental Illness Community Based Residential Treatment Facility
License Number
License Number State

VIII. Authorized Official

Name: NANA AFRIYIE HINTON
Title or Position: CEO
Credential:
Phone: 704-606-9243