=====================================================
General NPI Number Information
=====================================================
NPI Number | 1508064775
-----------------------------------------------------
Entity Type | Organization
-----------------------------------------------------
Legal Business Name | RITECARE LLC
-----------------------------------------------------
=====================================================
Dates
=====================================================
Enumeration Date | 07/10/2007
-----------------------------------------------------
Last Update Date | 06/05/2008
-----------------------------------------------------
=====================================================
Provider Practice Location Address
=====================================================
Address Line | 29240 BUCKINGHAM ST SUITE 2
-----------------------------------------------------
City | LIVONIA
-----------------------------------------------------
State | MI
-----------------------------------------------------
Zip | 48154-4575
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 734-266-9370
-----------------------------------------------------
Fax | 734-266-9371
-----------------------------------------------------
=====================================================
Provider Business Mailing Address
=====================================================
Address Line | 17197 N LAUREL PARK DR SUITE 138
-----------------------------------------------------
City | LIVONIA
-----------------------------------------------------
State | MI
-----------------------------------------------------
Zip | 48152-2680
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 734-462-1967
-----------------------------------------------------
Fax | 734-462-1971
-----------------------------------------------------
=====================================================
Authorized Official
=====================================================
Title or Position | PRESIDENT
-----------------------------------------------------
Name | MR. HANS LOBATO
-----------------------------------------------------
Credential |
-----------------------------------------------------
Telephone | 734-266-9370
-----------------------------------------------------
=====================================================
Scope of Practice (Provider's specialty)
=====================================================
Taxonomy #1
-----------------------------------------------------
Taxonomy Code | 207Q00000X
-----------------------------------------------------
Taxonomy Name | Family Medicine Physician
-----------------------------------------------------
License Number |
-----------------------------------------------------
License Number State |
-----------------------------------------------------