Healthcare Provider Details

I. General information

NPI: 1447798475
Provider Name (Legal Business Name): ROYALTY MENTORING INC.
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 02/09/2017
Last Update Date: 02/09/2017
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

301 BON AIR DR
WILLIAMSTOWN NJ
08094-8801
US

IV. Provider business mailing address

PO BOX 496
CLAYTON NJ
08312-0496
US

V. Phone/Fax

Practice location:
  • Phone: 856-214-2076
  • Fax:
Mailing address:
  • Phone: 856-214-2076
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code251V00000X
TaxonomyVoluntary or Charitable Agency
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code252Y00000X
TaxonomyEarly Intervention Provider Agency
License Number
License Number State

VIII. Authorized Official

Name: VENUS ANN DAVIS
Title or Position: FOUNDER/CEO
Credential:
Phone: 917-202-0377