MEDICARE: RETA, INC.

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	101YM0800X	Mental Health Counselor

General Provider Information

NPI Number	:	1649128737
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	RETA, INC.

Provider Business Mailing Address
First Line	:	116 W JACKSON BLVD
Second Line	:
City	:	ELKHART
State	:	IN
Zip	:	46516-3019
Country	:	US
Telephone Number	:	574-522-3888
Fax Number	:

Provider Business Practice Location Address
First Line	:	116 W JACKSON BLVD
Second Line	:
City	:	ELKHART
State	:	IN
Zip	:	46516-3019
Country	:	US
Telephone Number	:	574-522-3888
Fax Number	:

Authorized Official
Title or Position	:	CEO
Name	:	BRANDIE YODER
Credential	:	MPH, BSN, RN
Telephone Number	:	574-522-3888

Provider Enumeration Date	:	03/17/2026
Last Update Date	:	03/17/2026

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Directions to “RETA, INC. ” Practice Location

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