Organization
ROYAL MANOR II
Active
Organization subpart
No
Provider details
NPI number
Authorized official
VICKI RANDALL (ADMINISTRATOR)
(254) 666-2164
Entity
Organization
Contact information
Practice address
9101 PANTHER WAY, WACO, TX 76712-8614
(254) 235-9690
(254) 235-1394
Mailing address
12656 FM 2331, GODLEY, TX 76044-3329
(254) 666-2164
Taxonomy
Speciality
Code
Description
License number
State
314000000X
Skilled Nursing Facility
Primary
137613
TX
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
001021191
—
TX
Enumeration date
03/22/2013
Last updated
02/10/2014
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