Royal Wa Lacey LLC
NPI #1659022861 in Lacey, Washington
Provider Information
- NPI Number
- 1659022861
- Entity Type
- Organization
- Organization Name
- Royal Wa Lacey LLC
- Primary Specialty
- Substance Abuse Rehabilitation Facility
- Enumeration Date
- Jan 11, 2022
- Last Updated
- Mar 22, 2022
Practice Location
- Address
- 8649 MARTIN WAY E
- City
- Lacey
- State
- Washington
- ZIP Code
- 98516-5812
- Phone
- (888) 468-3389
Authorized Official
- Name
- SHANDALEE JACKSON
- Title
- CREDENTIALING MANAGER
- Phone
- (561) 562-6271
Specialties & Taxonomy Codes
| Specialty |
|---|
| Clinic/Center - Rehabilitation, Substance Use Disorder — Rehabilitation, Substance Use Disorder |
| Substance Abuse Rehabilitation Facility |
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