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Organization

ROYAL CARE INTEGRATED HEALTH LLC

Active
Organization subpart
No

Provider details

NPI number
Authorized official
DESHAWN WHITE (EXECUTIVE LEADERSHIP)
(614) 806-3075
Entity
Organization

Contact information

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

Taxonomy

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

Other

Enumeration date
04/12/2023
Last updated
04/12/2023
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