Provider Demographics
NPI:1578051595
Name:ROYAL BEHAVIOR ACADEMY LLC
Entity Type:Organization
Organization Name:ROYAL BEHAVIOR ACADEMY LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:RAYMARA
Authorized Official - Middle Name:
Authorized Official - Last Name:CASTRO
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:305-213-8424
Mailing Address - Street 1:1502 NE 9TH TER
Mailing Address - Street 2:
Mailing Address - City:CAPE CORAL
Mailing Address - State:FL
Mailing Address - Zip Code:33909-1567
Mailing Address - Country:US
Mailing Address - Phone:305-213-8424
Mailing Address - Fax:239-900-1995
Practice Address - Street 1:1502 NE 9TH TER
Practice Address - Street 2:
Practice Address - City:CAPE CORAL
Practice Address - State:FL
Practice Address - Zip Code:33909
Practice Address - Country:US
Practice Address - Phone:305-213-8424
Practice Address - Fax:239-900-1995
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2018-04-25
Last Update Date:2018-08-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes103K00000XBehavioral Health & Social Service ProvidersBehavior AnalystGroup - Multi-Specialty