Provider Demographics
NPI:1427581941
Name:ROYAL LIFE CENTERS, LLC
Entity Type:Organization
Organization Name:ROYAL LIFE CENTERS, LLC
Other - Org Name:CHAPTER 5 COUNSELING
Other - Org Type:Doing Business As
Authorized Official - Title/Position:DIRECTOR OF QUALITY ASSURANCE
Authorized Official - Prefix:MR
Authorized Official - First Name:ERIC
Authorized Official - Middle Name:
Authorized Official - Last Name:ANDREWS
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:928-379-3097
Mailing Address - Street 1:661 S SWINTON AVE
Mailing Address - Street 2:SUITE A
Mailing Address - City:DELRAY BEACH
Mailing Address - State:FL
Mailing Address - Zip Code:33444-3576
Mailing Address - Country:US
Mailing Address - Phone:954-304-3047
Mailing Address - Fax:800-871-3317
Practice Address - Street 1:818 W GURLEY ST
Practice Address - Street 2:
Practice Address - City:PRESCOTT
Practice Address - State:AZ
Practice Address - Zip Code:86305-3624
Practice Address - Country:US
Practice Address - Phone:877-732-6837
Practice Address - Fax:800-871-3317
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2017-04-11
Last Update Date:2017-05-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AZOTC8178251S00000X
AZOTC8179261QR0405X
AZBH5136324500000X
AZBH5137324500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes324500000XResidential Treatment FacilitiesSubstance Abuse Rehabilitation Facility
No251S00000XAgenciesCommunity/Behavioral Health
No261QR0405XAmbulatory Health Care FacilitiesClinic/CenterRehabilitation, Substance Use Disorder