Provider Demographics
NPI:1912218215
Name:ROYAL RECOVERY RESOURCES
Entity Type:Organization
Organization Name:ROYAL RECOVERY RESOURCES
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CEO
Authorized Official - Prefix:
Authorized Official - First Name:FRANK
Authorized Official - Middle Name:X
Authorized Official - Last Name:CID
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:561-866-0012
Mailing Address - Street 1:701 S SWINTON AVE APT G
Mailing Address - Street 2:
Mailing Address - City:DELRAY BEACH
Mailing Address - State:FL
Mailing Address - Zip Code:33444-2377
Mailing Address - Country:US
Mailing Address - Phone:561-455-2709
Mailing Address - Fax:
Practice Address - Street 1:701 S SWINTON AVE APT G
Practice Address - Street 2:
Practice Address - City:DELRAY BEACH
Practice Address - State:FL
Practice Address - Zip Code:33444-2377
Practice Address - Country:US
Practice Address - Phone:561-455-2709
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2010-07-01
Last Update Date:2013-02-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FL10D2005120291U00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes291U00000XLaboratoriesClinical Medical Laboratory