Organization
ROYAL CARE HOME LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
KENNETH K BALIAT (MANAGER)
(616) 514-8837
Entity
Organization
Contact information
Practice address
507 FULLER AVE SE, GRAND RAPIDS, MI 49506-2526
(616) 514-8837
Mailing address
2122 HARTSTONE DR SE, CALEDONIA, MI 49316-7880
(616) 514-8837
Taxonomy
Speciality
Code
Description
License number
State
320900000X
Intellectual and/or Developmental Disabilities Community Based Residential Treatment Facility
Primary
AS410347272
MI
Other
Enumeration date
02/22/2017
Last updated
02/22/2017
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