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General NPI Number Information
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NPI Number | 1083260798
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Entity Type | Organization
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Legal Business Name | RITECARE CONCEPT LLC
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Dates
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Enumeration Date | 08/18/2019
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Last Update Date | 06/01/2021
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Provider Practice Location Address
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Address Line | 11931 APPLING VALLEY RD
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City | FAIRFAX
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State | VA
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Zip | 22030-5701
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Country | US
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Telephone | 703-278-8076
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Fax | 703-743-6031
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Provider Business Mailing Address
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Address Line | 11931 APPLING VALLEY RD
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City | FAIRFAX
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State | VA
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Zip | 22030-5701
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Country | US
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Telephone | 703-278-8076
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Fax |
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Authorized Official
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Title or Position | DIRECTOR
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Name | ELLEN NENNE IDUMA
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Credential | DNP, FNP-BC
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Telephone | 703-278-8076
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 251S00000X
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Taxonomy Name | Community/Behavioral Health Agency
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License Number |
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License Number State |
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