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General NPI Number Information
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NPI Number | 1144682170
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Entity Type | Organization
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Legal Business Name | RITAS MINISTRY
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Dates
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Enumeration Date | 03/29/2016
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Last Update Date | 03/29/2016
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Provider Practice Location Address
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Address Line | 568 W GALENA BLVD
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City | AURORA
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State | IL
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Zip | 60506-3855
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Country | US
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Telephone | 630-966-0252
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Fax | 630-966-0005
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Provider Business Mailing Address
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Address Line | 568 W GALENA BLVD
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City | AURORA
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State | IL
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Zip | 60506
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Country | US
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Telephone | 630-966-0252
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Fax | 630-966-0005
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Authorized Official
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Title or Position | EXECUTIVE DIRECTOR
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Name | MRS. LINDA R MARTIN
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Credential |
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Telephone | 630-966-0252
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 101YA0400X
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Taxonomy Name | Addiction (Substance Use Disorder) Counselor
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License Number | A55460003A
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License Number State | IL
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