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Organization
MOBILEMOGULRURALHEALTHCLINIC
Active
Organization
MOBILEMOGULRURALHEALTHCLINIC
Active
Parent organization
ROYALRESPITE
Other names
RoyalRespite
Organization subpart
Yes
Provider details
NPI number
Legal business name
ROYALRESPITE
Authorized official
DORIS V WALKER CDCP (ADMINISTRATOR)
(262) 504-0241
Entity
Organization
Contact information
Practice address
35236 N WILSON RD, INGLESIDE, IL 60041
(262) 504-0241
Mailing address
PO BOX 70, FAIRFIELD, CA 94533-0006
Taxonomy
Speciality
Code
Description
License number
State
106S00000X
Behavior Technician
—
NULL
106S00000X
Behavior Technician
—
—
133NN1002X
Nutrition Education Nutritionist
—
NULL
133NN1002X
Nutrition Education Nutritionist
—
—
136A00000X
Registered Dietetic Technician
—
NULL
136A00000X
Registered Dietetic Technician
—
—
174200000X
Meals Provider
—
NULL
251E00000X
Home Health Agency
—
NULL
253Z00000X
In Home Supportive Care Agency
—
NULL
261QR1300X
Rural Health Clinic/Center
Primary
—
NULL
344600000X
Taxi
—
NULL
374U00000X
Home Health Aide
—
NULL
374U00000X
Home Health Aide
—
—
385H00000X
Respite Care
—
NULL
385HR2060X
Child Intellectual and/or Developmental Disabilities Respite Care
—
NULL
Other
Enumeration date
10/07/2024
Last updated
10/07/2024
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