Provider Demographics
NPI:1487821948
Name:ROYAL COMFORT ASSISTED LIVING FACILITY
Entity Type:Organization
Organization Name:ROYAL COMFORT ASSISTED LIVING FACILITY
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:EXECUTIVE DIRECTOR
Authorized Official - Prefix:MRS
Authorized Official - First Name:ANN-MARIE
Authorized Official - Middle Name:
Authorized Official - Last Name:CAMPBELL
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:772-344-8320
Mailing Address - Street 1:3173 SW LETCHWORTH ST
Mailing Address - Street 2:
Mailing Address - City:PORT ST LUCIE
Mailing Address - State:FL
Mailing Address - Zip Code:34953-4563
Mailing Address - Country:US
Mailing Address - Phone:772-344-8320
Mailing Address - Fax:772-344-8320
Practice Address - Street 1:3173 SW LETCHWORTH ST
Practice Address - Street 2:
Practice Address - City:PORT ST LUCIE
Practice Address - State:FL
Practice Address - Zip Code:34953-4563
Practice Address - Country:US
Practice Address - Phone:772-344-8320
Practice Address - Fax:772-344-8320
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2008-05-14
Last Update Date:2008-05-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes310400000XNursing & Custodial Care FacilitiesAssisted Living Facility