Provider Demographics
NPI:1831714302
Name:ROYAL BEHAVIORAL HEALTH SERVICES LLC
Entity type:Organization
Organization Name:ROYAL BEHAVIORAL HEALTH SERVICES LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CEO
Authorized Official - Prefix:
Authorized Official - First Name:ISIBHAKHOMEN
Authorized Official - Middle Name:
Authorized Official - Last Name:ESABU
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:623-755-0431
Mailing Address - Street 1:19432 N 3RD DR
Mailing Address - Street 2:
Mailing Address - City:PHOENIX
Mailing Address - State:AZ
Mailing Address - Zip Code:85027-4701
Mailing Address - Country:US
Mailing Address - Phone:623-755-0431
Mailing Address - Fax:
Practice Address - Street 1:19432 N 3RD DR
Practice Address - Street 2:
Practice Address - City:PHOENIX
Practice Address - State:AZ
Practice Address - Zip Code:85027-4701
Practice Address - Country:US
Practice Address - Phone:623-755-0431
Practice Address - Fax:602-825-1914
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:ROYAL BEHAVIORAL HEALTH SERVICES LLC
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2020-06-10
Last Update Date:2020-06-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes3104A0630XNursing & Custodial Care FacilitiesAssisted Living FacilityAssisted Living, Behavioral Disturbances