Provider Demographics
NPI:1730379173
Name:ROYAL TREATMENT HEALTH CARE SERVICES, INC
Entity type:Organization
Organization Name:ROYAL TREATMENT HEALTH CARE SERVICES, INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:DIRECTOR/HUMAN RESOURCES
Authorized Official - Prefix:MR
Authorized Official - First Name:VALENTINE
Authorized Official - Middle Name:C
Authorized Official - Last Name:NWAKIBU
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:301-975-9457
Mailing Address - Street 1:20713 DELTA DR
Mailing Address - Street 2:SUITE 1-B
Mailing Address - City:LAYTONSVILLE
Mailing Address - State:MD
Mailing Address - Zip Code:20882-1118
Mailing Address - Country:US
Mailing Address - Phone:301-975-9457
Mailing Address - Fax:301-975-9785
Practice Address - Street 1:20713 DELTA DR
Practice Address - Street 2:SUITE 1-B
Practice Address - City:LAYTONSVILLE
Practice Address - State:MD
Practice Address - Zip Code:20882-1118
Practice Address - Country:US
Practice Address - Phone:301-975-9457
Practice Address - Fax:301-975-9785
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-08-01
Last Update Date:2007-08-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MDD10217149251E00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251E00000XAgenciesHome Health
Provider Identifiers
StateIdentifier IDID TypeIssuer
MDR2413OtherMD DHMH (RSA)
MD0508007OtherMD DHMH (RSA)