MEDICARE: RICAHRD T PARKER SR.

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	251S00000X	Community/Behavioral Health Agency		OH
2	171M00000X	Case Manager/Care Coordinator		OH

General Provider Information

NPI Number	:	1386571321
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	RICAHRD T PARKER SR.

Provider Business Mailing Address
First Line	:	1119 ROCKCRESS DR
Second Line	:
City	:	TOLEDO
State	:	OH
Zip	:	43615-9240
Country	:	US
Telephone Number	:	419-494-7832
Fax Number	:

Provider Business Practice Location Address
First Line	:	1119 ROCKCRESS DR
Second Line	:
City	:	TOLEDO
State	:	OH
Zip	:	43615-9240
Country	:	US
Telephone Number	:	419-494-7832
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	05/05/2026
Last Update Date	:	05/05/2026

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