Royal Care Home LLC

Primary specialty

Intellectual and/or Developmental Disabilities Community Based Residential Treatment FacilityTaxonomy code 320900000X

License

AS410347272 Issued in MI

Legal business name

ROYAL CARE HOME LLC

Practice address

507 Fuller Ave SE
Grand Rapids, MI 49506-2526

Phone

(616) 514-8837

NPI assigned

Feb 22, 2017

Organization subpart

No

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

Authorized official

Name

Kenneth K Baliat

Title

Manager

Phone

(616) 514-8837

Specialties & licenses 1

Addresses

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

{
    "created_epoch": "1487721600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1487721600000",
    "number": "1851830947",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2122 HARTSTONE DR SE",
            "city": "CALEDONIA",
            "state": "MI",
            "postal_code": "493167880",
            "telephone_number": "616-514-8837"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "507 FULLER AVE SE",
            "city": "GRAND RAPIDS",
            "state": "MI",
            "postal_code": "495062526",
            "telephone_number": "616-514-8837"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "ROYAL CARE HOME LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2017-02-22",
        "last_updated": "2017-02-22",
        "status": "A",
        "authorized_official_last_name": "BALIAT",
        "authorized_official_first_name": "KENNETH",
        "authorized_official_middle_name": "K",
        "authorized_official_title_or_position": "MANAGER",
        "authorized_official_telephone_number": "616-514-8837"
    },
    "taxonomies": [
        {
            "code": "320900000X",
            "taxonomy_group": "",
            "desc": "Community Based Residential Treatment Facility, Intellectual and/or Developmental Disabilities",
            "state": "MI",
            "license": "AS410347272",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Amanda Marie Rowley, LMSW
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• Caroline Roy
• Matthew Roy
• Sarah Catherine Roy, NP
• Alivia Jean Royer
• Justin Royer, MD
• Erin Rozek
• William J Rozell, DO
• Amy Bourne Rozelle, PT

• Intellectual and/or Developmental Disabilities Community Based Residential Treatment Facility in Grand Rapids, MI
• Providers in Grand Rapids, MI by specialty
• Intellectual and/or Developmental Disabilities Community Based Residential Treatment Facility in Michigan

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 22, 2017; 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.