Provider Demographics
NPI:1952739195
Name:ROYAL MAYFLOWER INCORPORATION
Entity Type:Organization
Organization Name:ROYAL MAYFLOWER INCORPORATION
Other - Org Name:N/A
Other - Org Type:Other Name
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:PURITY
Authorized Official - Middle Name:MUTHONI
Authorized Official - Last Name:NGUNYI
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:682-221-6475
Mailing Address - Street 1:4737 N. O'CONNOR RD
Mailing Address - Street 2:1071
Mailing Address - City:IRVING
Mailing Address - State:TX
Mailing Address - Zip Code:75062
Mailing Address - Country:US
Mailing Address - Phone:682-221-6475
Mailing Address - Fax:
Practice Address - Street 1:4737 N. O'CONNOR RD
Practice Address - Street 2:1071
Practice Address - City:IRVING
Practice Address - State:TX
Practice Address - Zip Code:75062-2745
Practice Address - Country:US
Practice Address - Phone:682-221-6475
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2013-10-25
Last Update Date:2013-10-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes320900000XResidential Treatment FacilitiesCommunity Based Residential Treatment Facility, Intellectual and/or Developmental Disabilities