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General NPI Number Information
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NPI Number | 1174920169
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Entity Type | Organization
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Legal Business Name | ROYAL TREATMENT HEALTHCARE SERVICES, LLC
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Dates
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Enumeration Date | 11/19/2014
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Last Update Date | 11/19/2014
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Provider Practice Location Address
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Address Line | 4000 LEGATO RD STE. 1100
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City | FAIRFAX
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State | VA
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Zip | 22033-2892
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Country | US
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Telephone | 240-401-2876
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Fax |
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Provider Business Mailing Address
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Address Line | 19110 MONTGOMERY VILLAGE AVE STE. 303
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City | MONTGOMERY VILLAGE
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State | MD
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Zip | 20886-3702
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Country | US
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Telephone | 240-401-2876
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Fax |
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Authorized Official
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Title or Position | CEO
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Name | MS. CATENA OFFURUM
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Credential | RN
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Telephone | 240-401-2876
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 251E00000X
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Taxonomy Name | Home Health Agency
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License Number | R2413
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License Number State | MD
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