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General NPI Number Information
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NPI Number | 1811866387
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Entity Type | Organization
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Legal Business Name | ROYALE COVENANT CARE LLC
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Dates
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Enumeration Date | 11/03/2025
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Last Update Date | 11/03/2025
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Provider Practice Location Address
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Address Line | 8385 CHEROKEE BLVD STE 204-4
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City | DOUGLASVILLE
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State | GA
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Zip | 30134-2521
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Country | US
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Telephone | 404-855-1084
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Fax |
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Provider Business Mailing Address
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Address Line | 8385 CHEROKEE BLVD STE 204-4
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City | DOUGLASVILLE
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State | GA
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Zip | 30134-2521
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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 | OWNER/ CEO
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Name | ANISHA STREETER
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Credential |
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Telephone | 267-301-8184
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 251G00000X
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Taxonomy Name | Community Based Hospice Care Agency
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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 | 251J00000X
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Taxonomy Name | Nursing Care Agency
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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 | 332U00000X
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Taxonomy Name | Home Delivered Meals
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License Number |
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License Number State |
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Taxonomy #4
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Taxonomy Code | 251E00000X
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Taxonomy Name | Home Health Agency
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License Number |
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License Number State |
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