Healthcare Provider Details

I. General information

NPI: 1578013082
Provider Name (Legal Business Name): RIMYA SERVICES
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 10/07/2016
Last Update Date: 10/07/2016
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2545 W DIVERSEY AVE
CHICAGO IL
60647-7172
US

IV. Provider business mailing address

2545 W DIVERSEY AVE
CHICAGO IL
60647-7172
US

V. Phone/Fax

Practice location:
  • Phone: 708-465-1293
  • Fax:
Mailing address:
  • Phone: 708-465-1293
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code251S00000X
TaxonomyCommunity/Behavioral Health Agency
License Number
License Number State

VIII. Authorized Official

Name: JULIETA PEREZ
Title or Position: CEO
Credential:
Phone: 708-465-1293