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General NPI Number Information
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NPI Number | 1558096487
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Entity Type | Organization
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Legal Business Name | ROYAL MINDS INC
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Dates
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Enumeration Date | 07/25/2022
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Last Update Date | 08/09/2023
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Provider Practice Location Address
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Address Line | 2300 W MEADOWVIEW RD BLDG SUITE120
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City | GREENSBORO
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State | NC
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Zip | 27407-3720
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Country | US
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Telephone | 336-763-9200
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Fax |
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Provider Business Mailing Address
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Address Line | 2300 W MEADOWVIEW RD BLDG SUITE120
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City | GREENSBORO
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State | NC
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Zip | 27407-3720
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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 | EXECUTIVE DIRECTOR
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Name | MR. AL MUFTAU ADEITE
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Credential | LCSW-C
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Telephone | 240-486-1238
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 261QM0801X
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Taxonomy Name | Mental Health Clinic/Center (Including Community Mental Health Center)
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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 | 261QR0405X
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Taxonomy Name | Substance Use Disorder Rehabilitation Clinic/Center
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License Number |
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License Number State |
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Taxonomy #3
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Taxonomy Code | 251S00000X
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Taxonomy Name | Community/Behavioral Health Agency
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License Number |
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License Number State |
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