Provider Demographics
NPI:1972237352
Name:RICKY, INC
Entity Type:Organization
Organization Name:RICKY, INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CEO
Authorized Official - Prefix:MRS
Authorized Official - First Name:JENNIFER
Authorized Official - Middle Name:
Authorized Official - Last Name:MCCORMICK
Authorized Official - Suffix:
Authorized Official - Credentials:MA
Authorized Official - Phone:615-430-5202
Mailing Address - Street 1:418 HIGHWAY 96 N
Mailing Address - Street 2:
Mailing Address - City:FAIRVIEW
Mailing Address - State:TN
Mailing Address - Zip Code:37062-9261
Mailing Address - Country:US
Mailing Address - Phone:615-430-5202
Mailing Address - Fax:
Practice Address - Street 1:418 HIGHWAY 96 N
Practice Address - Street 2:
Practice Address - City:FAIRVIEW
Practice Address - State:TN
Practice Address - Zip Code:37062-9261
Practice Address - Country:US
Practice Address - Phone:615-430-5202
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2022-07-12
Last Update Date:2022-07-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251E00000XAgenciesHome Health