Provider Demographics
NPI:1306414677
Name:ROYAL CARE SERVICE, LLC
Entity Type:Organization
Organization Name:ROYAL CARE SERVICE, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:JOY
Authorized Official - Middle Name:N
Authorized Official - Last Name:MOSERI-COOPER
Authorized Official - Suffix:
Authorized Official - Credentials:DBA, MA, LPC, SAP
Authorized Official - Phone:404-702-9821
Mailing Address - Street 1:1607 BARRINGTON VW
Mailing Address - Street 2:
Mailing Address - City:STONE MOUNTAIN
Mailing Address - State:GA
Mailing Address - Zip Code:30087-1846
Mailing Address - Country:US
Mailing Address - Phone:404-702-9821
Mailing Address - Fax:
Practice Address - Street 1:1607 BARRINGTON VW
Practice Address - Street 2:
Practice Address - City:STONE MOUNTAIN
Practice Address - State:GA
Practice Address - Zip Code:30087-1846
Practice Address - Country:US
Practice Address - Phone:404-702-9821
Practice Address - Fax:678-705-3735
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2021-06-14
Last Update Date:2021-06-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251E00000XAgenciesHome Health