NPIMap

Organization Active NPI

Royal Life Centers, LLC

  • Substance Use Disorder Rehabilitation Clinic/Center
  • Prescott, AZ
National Provider Identifier
1295110476
Registry record updated May 30, 2019
On this page

Key facts

NPPES NPI Registry
Primary specialty
Substance Use Disorder Rehabilitation Clinic/CenterTaxonomy code 261QR0405X
License
OTC8105 Issued in AZ
Legal business name
ROYAL LIFE CENTERS, LLC
Practice address
655 W Gurley St
Prescott, AZ 86305-3619
Phone
(877) 732-6837
NPI assigned
Jul 29, 2015
Organization subpart
No

NPPES NPI Registry

Updated by the provider on May 30, 2019

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name
Mr. Eric Andrews
Title
Director of Quality Assurance
Phone
(928) 379-3097

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Substance Use Disorder Rehabilitation Clinic/Center 261QR0405X OTC8105 AZ Primary

Addresses

Primary practice location

655 W Gurley St
Prescott, AZ 86305-3619

Mailing address

661 S Swinton Ave
Suite a
Delray Beach, FL 33444-3576
Phone (928) 515-2373

Other practice location 1

1040 Whipple St
Suites 323-344
Prescott, AZ 86305-1613
Phone (928) 515-2373

Other names 1

  • Royal Life Centers Doing business as

National Provider Directory

National Provider Directory
Tax ID family
Chapter 5 Counseling3 organizations share this tax ID, including this one

Other organizations with this tax ID 2

Organizations that report the same tax identification number in the National Provider Directory.

Locations

655 W Gurley St
Prescott, AZ 86305
Phone (855) 468-3369

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1438128000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1559174400000",
    "number": "1295110476",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "661 S SWINTON AVE",
            "address_2": "SUITE A",
            "city": "DELRAY BEACH",
            "state": "FL",
            "postal_code": "334443576",
            "telephone_number": "928-515-2373",
            "fax_number": "928-771-3705"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "655 W GURLEY ST",
            "city": "PRESCOTT",
            "state": "AZ",
            "postal_code": "863053619",
            "telephone_number": "877-732-6837"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "1040 Whipple St",
            "address_2": "Suites 323-344",
            "address_purpose": "LOCATION",
            "city": "Prescott",
            "state": "AZ",
            "postal_code": "863051613",
            "country_code": "US",
            "telephone_number": "928-515-2373",
            "fax_number": "928-771-3705",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "organization_name": "ROYAL LIFE CENTERS, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2015-07-29",
        "last_updated": "2019-05-30",
        "status": "A",
        "authorized_official_last_name": "ANDREWS",
        "authorized_official_first_name": "ERIC",
        "authorized_official_title_or_position": "DIRECTOR OF QUALITY ASSURANCE",
        "authorized_official_telephone_number": "928-379-3097",
        "authorized_official_name_prefix": "Mr."
    },
    "taxonomies": [
        {
            "code": "261QR0405X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Rehabilitation, Substance Use Disorder",
            "state": "AZ",
            "license": "OTC8105",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Royal Life Centers",
            "code": "3",
            "type": "Doing Business As"
        },
        {
            "organization_name": "Royal Life Centers",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Prescott, AZ

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 30, 2019; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.