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General NPI Number Information
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NPI Number | 1528833365
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Entity Type | Organization
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Legal Business Name | RYDER SPECIALIZED CARE LLC
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Dates
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Enumeration Date | 11/21/2023
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Last Update Date | 11/21/2023
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Provider Practice Location Address
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Address Line | 34 BYRON ST
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City | BATTLE CREEK
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State | MI
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Zip | 49017-4860
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Country | US
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Telephone | 269-578-3454
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Fax |
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Provider Business Mailing Address
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Address Line | 24049 M 78
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City | BATTLE CREEK
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State | MI
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Zip | 49017-9737
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Country | US
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Telephone | 269-578-3454
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Fax |
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Authorized Official
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Title or Position | LICENSEE
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Name | MR. JAMES HOWARD RUOFF
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Credential |
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Telephone | 269-578-3454
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 320800000X
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Taxonomy Name | Mental Illness Community Based Residential Treatment Facility
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License Number |
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License Number State |
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