Healthcare Provider Details

I. General information

NPI: 1336437912
Provider Name (Legal Business Name): ROYALE HEALTHCARE, LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 07/15/2011
Last Update Date: 07/15/2011
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

8520 SIX FORKS RD SUITE 201
RALEIGH NC
27615-3095
US

IV. Provider business mailing address

PO BOX 99761
RALEIGH NC
27624-9761
US

V. Phone/Fax

Practice location:
  • Phone: 919-349-6959
  • Fax: 206-984-0964
Mailing address:
  • Phone: 919-349-6959
  • Fax: 206-984-0964

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 Code253Z00000X
TaxonomyIn Home Supportive Care Agency
License Number
License Number State

VIII. Authorized Official

Name: MRS. ANITA OUTLAW KING
Title or Position: OWNER
Credential:
Phone: 919-349-6959