Healthcare Provider Details

I. General information

NPI: 1992921852
Provider Name (Legal Business Name): ROYAL PROFESSIONAL SERVICES, INC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 04/18/2007
Last Update Date: 04/01/2010
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

6488 GLENWAY AVENUE SUITE N
CINCINNATI OH
45211-5500
US

IV. Provider business mailing address

6488 GLENWAY AVENUE SUITE N
CINCINNATI OH
45211-5500
US

V. Phone/Fax

Practice location:
  • Phone: 513-389-7634
  • Fax: 513-389-7633
Mailing address:
  • Phone: 513-389-7634
  • Fax: 513-389-7633

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code251J00000X
TaxonomyNursing Care Agency
License NumberCP5516
License Number StateOH
# 2
Primary TaxonomyY
Taxonomy Code251E00000X
TaxonomyHome Health Agency
License NumberCP5516
License Number StateOH

VIII. Authorized Official

Name: MR. JOSEPH GERALD WAKLATSI
Title or Position: ADMINISTRATOR
Credential: RN
Phone: 513-389-7634