Provider Demographics
NPI:1598915464
Name:ROYAL RESIDENTIAL SERVICES
Entity Type:Organization
Organization Name:ROYAL RESIDENTIAL SERVICES
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:GREGORY
Authorized Official - Middle Name:A
Authorized Official - Last Name:OGBUE
Authorized Official - Suffix:
Authorized Official - Credentials:B PHARM
Authorized Official - Phone:301-379-1564
Mailing Address - Street 1:13918 CHADSWORTH TER
Mailing Address - Street 2:
Mailing Address - City:LAUREL
Mailing Address - State:MD
Mailing Address - Zip Code:20707-9440
Mailing Address - Country:US
Mailing Address - Phone:301-741-4221
Mailing Address - Fax:
Practice Address - Street 1:5125 GEORGIA AVE NW
Practice Address - Street 2:
Practice Address - City:WASHINGTON
Practice Address - State:DC
Practice Address - Zip Code:20011-3921
Practice Address - Country:US
Practice Address - Phone:301-379-1564
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2008-09-26
Last Update Date:2008-09-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
DC16740320600000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes320600000XResidential Treatment FacilitiesResidential Treatment Facility, Intellectual and/or Developmental Disabilities