MEDICARE: RILEY CONSULTING GROUP LLC

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	261QM0801X	Mental Health Clinic/Center (Including Community Mental Health Center)
2	261QH0100X	Health Service Clinic/Center

General Provider Information

NPI Number	:	1093661167
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	RILEY CONSULTING GROUP LLC

Provider Business Mailing Address
First Line	:	1213 LOYALTY LN
Second Line	:
City	:	WYLIE
State	:	TX
Zip	:	75098-1995
Country	:	US
Telephone Number	:	323-244-0400
Fax Number	:

Provider Business Practice Location Address
First Line	:	1213 LOYALTY LN
Second Line	:
City	:	WYLIE
State	:	TX
Zip	:	75098-1995
Country	:	US
Telephone Number	:	323-244-0400
Fax Number	:

Authorized Official
Title or Position	:	OWNER
Name	:	RALF WANCHA
Credential	:	APRN
Telephone Number	:	323-244-0400

Provider Enumeration Date	:	03/10/2026
Last Update Date	:	05/04/2026

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Directions to “RILEY CONSULTING GROUP LLC ” Practice Location

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