Provider Demographics
NPI:1568014504
Name:ROYAL MINDS INC.
Entity Type:Organization
Organization Name:ROYAL MINDS INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CEO
Authorized Official - Prefix:
Authorized Official - First Name:AL MUFTAU
Authorized Official - Middle Name:A
Authorized Official - Last Name:ADEITE
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:240-486-1238
Mailing Address - Street 1:3717 E BALTIMORE ST
Mailing Address - Street 2:
Mailing Address - City:BALTIMORE
Mailing Address - State:MD
Mailing Address - Zip Code:21224-1509
Mailing Address - Country:US
Mailing Address - Phone:240-486-1238
Mailing Address - Fax:
Practice Address - Street 1:3717 E BALTIMORE ST
Practice Address - Street 2:
Practice Address - City:BALTIMORE
Practice Address - State:MD
Practice Address - Zip Code:21224-1509
Practice Address - Country:US
Practice Address - Phone:240-486-1238
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2019-07-10
Last Update Date:2020-02-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QR0405XAmbulatory Health Care FacilitiesClinic/CenterRehabilitation, Substance Use Disorder
No261QR0400XAmbulatory Health Care FacilitiesClinic/CenterRehabilitation