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General NPI Number Information
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NPI Number | 1487717377
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Entity Type | Organization
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Legal Business Name | ROYALTEE IN-HOME SERVICE, LLCV
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Dates
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Enumeration Date | 12/19/2006
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Last Update Date | 05/10/2017
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Provider Practice Location Address
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Address Line | 111 W CHURCH ST
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City | QUITMAN
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State | MS
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Zip | 39355-2134
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Country | US
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Telephone | 601-776-3230
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Fax | 601-776-3231
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Provider Business Mailing Address
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Address Line | 111 W CHURCH ST
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City | QUITMAN
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State | MS
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Zip | 39355-2134
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Country | US
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Telephone | 601-776-3230
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Fax | 601-776-3231
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Authorized Official
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Title or Position | OWNER SINGLE MEMBER
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Name | ROSIE M BERRY
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Credential |
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Telephone | 601-776-3230
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 385H00000X
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Taxonomy Name | Respite Care
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License Number |
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License Number State |
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Taxonomy #2
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Taxonomy Code | 376J00000X
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Taxonomy Name | Homemaker
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License Number |
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License Number State |
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