ROYAL HEALTH & WELLNESS CLINIC LLC NPI 1326676479

NPI Information

NPI: 1326676479
Provider Name: ROYAL HEALTH & WELLNESS CLINIC LLC
Classification: Nurse Practitioner - 363LP0808X
Entity Type: Organization

Specialization: Psychiatric/Mental Health

CLIA Number: 19D2210071

Address:
850 KALISTE SALOOM RD STE 104
LAFAYETTE, LA
ZIP 70508
Phone: (337) 281-9144
Get Directions

ROYAL HEALTH & WELLNESS CLINIC LLC is a psychiatric/mental health nurse practitioner in Lafayette, LA. ROYAL HEALTH & WELLNESS CLINIC LLC NPI is 1326676479. The provider is registered as an organization entity type.

The provider's business location address is:

850 KALISTE SALOOM RD STE 104
LAFAYETTE, LA
ZIP 70508-230
Phone: (337) 281-9144

The provider's authorized official is Helen Ajala .
The authorized official title is FAMILY NURSE PRACTITIONER/ PMHNPPmhnp and has the following contact phone number (337) 739-2058.

The CLIA number assigned to this NPI record is 19D2210071 - physician office with a certificate type of Certificate of Waiver.

The enumeration date for this NPI number is 4/1/2020 and was last updated on 7/14/2021.

Taxonomy Codes

The NPI record includes the healthcare provider taxonomy classification, state license number and state of licensure. The following information regarding the scope of practice of this provider is available:

No.	Taxonomy Code	Taxonomy Clasification	Taxonomy Specialization	Primary
1	261Q00000X	Clinic/Center		No
2	261QP2300X	Clinic/Center	Primary Care	No
3	363LF0000X	Nurse Practitioner	Family	No
4	363LP0808X	Nurse Practitioner	Psychiatric/Mental Health	Yes
5	363LP2300X	Nurse Practitioner	Primary Care	No

Other Identifiers

The following information regarding additional identifiers associated to this NPI record includes the other identifier number, identifier type, identifier state and issuer.

No.	Other Provider Identifier	Other Provider Identifier Type	Other Provider Identifier State	Other Provider Identifier Issuer
1	2436082	MEDICAID	LOUISIANA

What is NPI?

NPI stands for National Provider Identifier. The NPI is a 10-digit identification number that is completely unique. The NPI number by itself does not contain any identifiable information such as a provider’s speciality or location. The NPI is assigned to individuals or organizacions for their lifespan and it is independent of key provider information type updates like a change of practices, location or speciality.

This page was last updated on: 4/28/2024

NPI Synchronization or Removal

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