Healthcare Provider Details

I. General information

NPI: 1225585417
Provider Name (Legal Business Name): ROYAL AT HOME RI LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 09/06/2016
Last Update Date: 10/30/2024
Certification Date: 10/11/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

193 FOREST AVE
MIDDLETOWN RI
02842-4625
US

IV. Provider business mailing address

193 FOREST AVE
MIDDLETOWN RI
02842-4625
US

V. Phone/Fax

Practice location:
  • Phone: 401-848-6000
  • Fax:
Mailing address:
  • Phone: 401-847-2777
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code251E00000X
TaxonomyHome Health Agency
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code251J00000X
TaxonomyNursing Care Agency
License Number
License Number State
# 3
Primary TaxonomyN
Taxonomy Code310400000X
TaxonomyAssisted Living Facility
License Number
License Number State

VIII. Authorized Official

Name: KRISTIE CELORIER
Title or Position: DIRECTOR OF AR
Credential:
Phone: 774-302-4366