Healthcare Provider Details
I. General information
NPI: 1407797640
Provider Name (Legal Business Name): ROYA HEALTH, LLC
Entity Type: Organization
Gender:
Sole Proprietor:
II. Dates (important events)
Enumeration Date: 04/02/2026
Last Update Date: 04/02/2026
Certification Date: 04/02/2026
Deactivation Date:
Reactivation Date:
III. Provider practice location address
4317 LEAD AVE SE
ALBUQUERQUE NM
87108-2724
US
IV. Provider business mailing address
1345 E MAIN ST STE 104
MESA AZ
85203-8950
US
V. Phone/Fax
- Phone: 602-341-3473
- Fax:
- Phone: 602-341-3473
- Fax:
VI. Provider taxonomy
Scope of Practice (Provider specialty)
| # 1 | |
| Primary Taxonomy | N |
| Taxonomy Code | 363LP0808X |
| Taxonomy | Psychiatric/Mental Health Nurse Practitioner |
| License Number | |
| License Number State | |
| # 2 | |
| Primary Taxonomy | Y |
| Taxonomy Code | 2084P0800X |
| Taxonomy | Psychiatry Physician |
| License Number | |
| License Number State | |
VIII. Authorized Official
Name:
JOHN
MCNEAL
Title or Position: MANAGER
Credential:
Phone: 678-642-3532