Provider Demographics
NPI:1912512187
Name:ROYALL SERVICES LLC
Entity Type:Organization
Organization Name:ROYALL SERVICES LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CHIEF EXECUTIVE OFFICER
Authorized Official - Prefix:
Authorized Official - First Name:CRYSTAL
Authorized Official - Middle Name:
Authorized Official - Last Name:COUNCIL
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:757-238-1091
Mailing Address - Street 1:519 W 35TH ST
Mailing Address - Street 2:
Mailing Address - City:NORFOLK
Mailing Address - State:VA
Mailing Address - Zip Code:23508-3101
Mailing Address - Country:US
Mailing Address - Phone:757-937-1109
Mailing Address - Fax:757-937-8945
Practice Address - Street 1:519 W 35TH ST
Practice Address - Street 2:
Practice Address - City:NORFOLK
Practice Address - State:VA
Practice Address - Zip Code:23508-3101
Practice Address - Country:US
Practice Address - Phone:757-937-1109
Practice Address - Fax:757-937-8945
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2020-09-14
Last Update Date:2020-09-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QM0801XAmbulatory Health Care FacilitiesClinic/CenterMental Health (Including Community Mental Health Center)