MEDICARE: ROYAL SAFE HAVEN

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	374U00000X	Home Health Aide
2	372600000X	Adult Companion

General Provider Information

NPI Number	:	1033064266
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	ROYAL SAFE HAVEN

Provider Business Mailing Address
First Line	:	957 MAIN ST STE 131
Second Line	:
City	:	STONE MOUNTAIN
State	:	GA
Zip	:	30083-3060
Country	:	US
Telephone Number	:	404-597-2390
Fax Number	:

Provider Business Practice Location Address
First Line	:	957 MAIN ST STE 131
Second Line	:
City	:	STONE MOUNTAIN
State	:	GA
Zip	:	30083-3060
Country	:	US
Telephone Number	:	404-597-2390
Fax Number	:

Authorized Official
Title or Position	:	MEMBER
Name	:	GWENDOLYN RENEE SHUMATE-WILLIAMS
Credential	:	SHUMATE-WILLIAMS
Telephone Number	:	404-597-2390

Provider Enumeration Date	:	03/03/2026
Last Update Date	:	03/03/2026

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Directions to “ROYAL SAFE HAVEN ” Practice Location

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