Provider Demographics
NPI:1386895381
Name:RICKCARE, LLC
Entity type:Organization
Organization Name:RICKCARE, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:MANAGING MEMBER
Authorized Official - Prefix:MR
Authorized Official - First Name:TIMOTHY
Authorized Official - Middle Name:D
Authorized Official - Last Name:WOODARD
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:217-202-6113
Mailing Address - Street 1:2490 COUNTY ROAD 550 E
Mailing Address - Street 2:
Mailing Address - City:DEWEY
Mailing Address - State:IL
Mailing Address - Zip Code:61840-9725
Mailing Address - Country:US
Mailing Address - Phone:217-202-6113
Mailing Address - Fax:928-244-2148
Practice Address - Street 1:2490 COUNTY ROAD 550 E
Practice Address - Street 2:
Practice Address - City:DEWEY
Practice Address - State:IL
Practice Address - Zip Code:61840-9725
Practice Address - Country:US
Practice Address - Phone:217-202-6113
Practice Address - Fax:928-244-2148
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2008-10-08
Last Update Date:2008-10-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes311ZA0620XNursing & Custodial Care FacilitiesCustodial Care FacilityAdult Care Home