Provider Demographics
NPI:1992921852
Name:ROYAL PROFESSIONAL SERVICES, INC
Entity type:Organization
Organization Name:ROYAL PROFESSIONAL SERVICES, INC
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:ADMINISTRATOR
Authorized Official - Prefix:MR
Authorized Official - First Name:JOSEPH
Authorized Official - Middle Name:GERALD
Authorized Official - Last Name:WAKLATSI
Authorized Official - Suffix:
Authorized Official - Credentials:RN
Authorized Official - Phone:513-389-7634
Mailing Address - Street 1:6488 GLENWAY AVENUE
Mailing Address - Street 2:SUITE N
Mailing Address - City:CINCINNATI
Mailing Address - State:OH
Mailing Address - Zip Code:45211-5500
Mailing Address - Country:US
Mailing Address - Phone:513-389-7634
Mailing Address - Fax:513-389-7633
Practice Address - Street 1:6488 GLENWAY AVENUE
Practice Address - Street 2:SUITE N
Practice Address - City:CINCINNATI
Practice Address - State:OH
Practice Address - Zip Code:45211-5500
Practice Address - Country:US
Practice Address - Phone:513-389-7634
Practice Address - Fax:513-389-7633
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-04-18
Last Update Date:2010-04-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OHCP5516251E00000X, 251J00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251E00000XAgenciesHome Health
No251J00000XAgenciesNursing Care