Provider Demographics
NPI:1629548748
Name:THE ROYAL PLACE INC
Entity Type:Organization
Organization Name:THE ROYAL PLACE INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER/MANAGER
Authorized Official - Prefix:
Authorized Official - First Name:VIRGINIA
Authorized Official - Middle Name:DURIAN
Authorized Official - Last Name:LASAM
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:702-476-1533
Mailing Address - Street 1:3644 MOUNTCREST DR
Mailing Address - Street 2:
Mailing Address - City:LAS VEGAS
Mailing Address - State:NV
Mailing Address - Zip Code:89121-4918
Mailing Address - Country:US
Mailing Address - Phone:702-476-1533
Mailing Address - Fax:702-982-0048
Practice Address - Street 1:3644 MOUNTCREST DR
Practice Address - Street 2:
Practice Address - City:LAS VEGAS
Practice Address - State:NV
Practice Address - Zip Code:89121-4918
Practice Address - Country:US
Practice Address - Phone:702-476-1533
Practice Address - Fax:702-982-0048
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2018-12-01
Last Update Date:2019-06-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes311ZA0620XNursing & Custodial Care FacilitiesCustodial Care FacilityAdult Care Home