MEDICARE: RIGHTEOUS CARE, 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	251C00000X	Developmentally Disabled Services Day Training Agency

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1811642408
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	RIGHTEOUS CARE, LLC.

Provider Business Mailing Address
First Line	:	5251 RED CEDAR DR APT 21
Second Line	:
City	:	FORT MYERS
State	:	FL
Zip	:	33907-7508
Country	:	US
Telephone Number	:	239-271-8668
Fax Number	:

Provider Business Practice Location Address
First Line	:	5251 RED CEDAR DR APT 21
Second Line	:
City	:	FORT MYERS
State	:	FL
Zip	:	33907-7508
Country	:	US
Telephone Number	:	239-271-8668
Fax Number	:

Authorized Official
Title or Position	:	OWNER
Name	:	JAMES WHITE JR.
Credential	:
Telephone Number	:	239-271-8668

Provider Enumeration Date	:	02/13/2022
Last Update Date	:	02/13/2022

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