Organization
ROYAL OUTPATIENT CLINIC LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
ISIBHAKHOMEN ESABU (ADMINISTRATOR)
(623) 606-5661
Entity
Organization
Contact information
Practice address
5060 N 19TH AVE STE 215, PHOENIX, AZ 85015-3212
(623) 606-5661
Mailing address
13323 W SOLANO DR, LITCHFIELD PARK, AZ 85340-7360
(623) 606-5661
Taxonomy
Speciality
Code
Description
License number
State
261QM0850X
Adult Mental Health Clinic/Center
Primary
—
—
Other
Enumeration date
10/19/2022
Last updated
10/19/2022
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