Provider Demographics
NPI:1902554355
Name:ROYAL HEALTH CARE SERVICES
Entity type:Organization
Organization Name:ROYAL HEALTH CARE SERVICES
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:ADMINISTRATOR
Authorized Official - Prefix:MS
Authorized Official - First Name:SUSAN
Authorized Official - Middle Name:
Authorized Official - Last Name:KIMERIA
Authorized Official - Suffix:
Authorized Official - Credentials:FOUNDER
Authorized Official - Phone:407-535-8148
Mailing Address - Street 1:230 E. NEW YORK AVE
Mailing Address - Street 2:
Mailing Address - City:DELAND
Mailing Address - State:FL
Mailing Address - Zip Code:32724-5522
Mailing Address - Country:US
Mailing Address - Phone:386-624-6933
Mailing Address - Fax:386-774-1203
Practice Address - Street 1:230 E. NEW YORK AVENUE
Practice Address - Street 2:
Practice Address - City:DELAND
Practice Address - State:FL
Practice Address - Zip Code:32724-5522
Practice Address - Country:US
Practice Address - Phone:386-456-3224
Practice Address - Fax:386-774-1203
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:ROYAL HEALTH CARE SERVICES
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2022-03-15
Last Update Date:2025-03-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251S00000XAgenciesCommunity/Behavioral Health
No251B00000XAgenciesCase Management
Provider Identifiers
StateIdentifier IDID TypeIssuer
FL116025500Medicaid
FL880711Medicaid