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General NPI Number Information
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NPI Number | 1083400261
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Entity Type | Organization
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Legal Business Name | ROYAL WA VANCOUVER, LLC
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Dates
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Enumeration Date | 04/16/2025
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Last Update Date | 04/16/2025
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Provider Practice Location Address
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Address Line | 8422 NE 8TH WAY
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City | VANCOUVER
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State | WA
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Zip | 98664-1974
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Country | US
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Telephone | 509-768-3953
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Fax |
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Provider Business Mailing Address
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Address Line | 1590 S CONGRESS AVE
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City | PALM SPRINGS
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State | FL
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Zip | 33406-5957
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Country | US
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Telephone |
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Fax |
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Authorized Official
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Title or Position | ADMINISTRATOR
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Name | CHRISTOPHER BRINEY
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Credential |
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Telephone | 805-512-1695
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 324500000X
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Taxonomy Name | Substance Abuse Rehabilitation Facility
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License Number |
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License Number State |
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