Provider Demographics
NPI:1083260798
Name:RITECARE CONCEPT LLC
Entity Type:Organization
Organization Name:RITECARE CONCEPT LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:DIRECTOR
Authorized Official - Prefix:
Authorized Official - First Name:ELLEN
Authorized Official - Middle Name:NENNE
Authorized Official - Last Name:IDUMA
Authorized Official - Suffix:
Authorized Official - Credentials:DNP, FNP-BC
Authorized Official - Phone:703-278-8076
Mailing Address - Street 1:11931 APPLING VALLEY RD
Mailing Address - Street 2:
Mailing Address - City:FAIRFAX
Mailing Address - State:VA
Mailing Address - Zip Code:22030-5701
Mailing Address - Country:US
Mailing Address - Phone:703-278-8076
Mailing Address - Fax:
Practice Address - Street 1:11931 APPLING VALLEY RD
Practice Address - Street 2:
Practice Address - City:FAIRFAX
Practice Address - State:VA
Practice Address - Zip Code:22030-5701
Practice Address - Country:US
Practice Address - Phone:703-278-8076
Practice Address - Fax:703-743-6031
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2019-08-18
Last Update Date:2021-06-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251S00000XAgenciesCommunity/Behavioral Health