Provider Demographics
NPI:1891559464
Name:ROYAL FAMILY DIRECT CARE SERVICES LLC
Entity Type:Organization
Organization Name:ROYAL FAMILY DIRECT CARE SERVICES LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:EXECUTIVE DIRECTOR
Authorized Official - Prefix:
Authorized Official - First Name:CHARLNISHIA
Authorized Official - Middle Name:
Authorized Official - Last Name:WILKINS
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:314-445-8304
Mailing Address - Street 1:11138 OLD SAINT CHARLES RD
Mailing Address - Street 2:
Mailing Address - City:SAINT ANN
Mailing Address - State:MO
Mailing Address - Zip Code:63074-2113
Mailing Address - Country:US
Mailing Address - Phone:314-755-1095
Mailing Address - Fax:
Practice Address - Street 1:11138 OLD SAINT CHARLES RD
Practice Address - Street 2:
Practice Address - City:SAINT ANN
Practice Address - State:MO
Practice Address - Zip Code:63074-2113
Practice Address - Country:US
Practice Address - Phone:314-755-1095
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2024-02-13
Last Update Date:2024-03-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251E00000XAgenciesHome Health