# ROYAL CARE INTEGRATED HEALTH LLC

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- **Entity:** Organization
- **Status:** Active
- **Organization subpart:** No

## Provider details

- **NPI number:** 1083300172
- **Authorized official:** DESHAWN WHITE (EXECUTIVE LEADERSHIP)
- **Authorized official phone:** (614) 806-3075

## Contact information

- **Practice address:** 648 N 5TH AVE, PHOENIX, AZ 85003-1529
- **Practice address phone:** (614) 806-3075
- **Mailing address:** 5330 W BOWKER ST, LAVEEN, AZ 85339-2467
- **Mailing address phone:** (614) 806-3075

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 207Q00000X | Family Medicine Physician | — | NULL | Yes |
| 207Q00000X | Family Medicine Physician | — | — | Yes |
| 251B00000X | Case Management Agency | — | NULL | — |
| 251S00000X | Community/Behavioral Health Agency | — | NULL | — |
| 261QD0000X | Dental Clinic/Center | — | NULL | — |
| 261QM0850X | Adult Mental Health Clinic/Center | — | NULL | — |
| 332800000X | Indian Health Service/Tribal/Urban Indian Health (I/T/U) Pharmacy | — | NULL | — |
| 343900000X | Non-emergency Medical Transport (VAN) | — | NULL | — |

## Other

- **Enumeration date:** 04/12/2023
- **Last updated:** 04/12/2023