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Organization

ROYALRESPITE

Active
Parent organization
000000
Other names
ROYALRESPITE, WELLNESSHOPPE, Wellness Shoppe, MOBILEMOGUL
Organization subpart
Yes

Provider details

NPI number
Legal business name
000000
Authorized official
DORIS V WALEKR CDCP (OWNER)
(262) 504-0241
Entity
Organization

Contact information

Practice address
255 N MEMORIAL DR, RACINE, WI 53404-3428
(262) 504-0241
Mailing address
255 N MEMORIAL DR, RACINE, WI 53404-3428
(262) 504-0241

Taxonomy

Speciality
Code
Description
License number
State
103TA0400X
Addiction (Substance Use Disorder) Psychologist
106S00000X
Behavior Technician
133NN1002X
Nutrition Education Nutritionist
163WH1000X
Hospice Registered Nurse
2278E0002X
Emergency Care Certified Respiratory Therapist
251E00000X
Home Health Agency
251T00000X
PACE Provider Organization
252Y00000X
Early Intervention Provider Agency
253Z00000X
In Home Supportive Care Agency
261QG0250X
Genetics Clinic/Center
261QR1300X
Rural Health Clinic/Center
Primary
311ZA0620X
Adult Care Home Facility
385H00000X
Respite Care
385HR2050X
Respite Care Camp
385HR2060X
Child Intellectual and/or Developmental Disabilities Respite Care

Other

Enumeration date
08/01/2024
Last updated
09/13/2024
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