Provider Demographics
NPI:1528833365
Name:RYDER SPECIALIZED CARE LLC
Entity type:Organization
Organization Name:RYDER SPECIALIZED CARE LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:LICENSEE
Authorized Official - Prefix:MR
Authorized Official - First Name:JAMES
Authorized Official - Middle Name:HOWARD
Authorized Official - Last Name:RUOFF
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:269-578-3454
Mailing Address - Street 1:24049 M 78
Mailing Address - Street 2:
Mailing Address - City:BATTLE CREEK
Mailing Address - State:MI
Mailing Address - Zip Code:49017-9737
Mailing Address - Country:US
Mailing Address - Phone:269-578-3454
Mailing Address - Fax:
Practice Address - Street 1:34 BYRON ST
Practice Address - Street 2:
Practice Address - City:BATTLE CREEK
Practice Address - State:MI
Practice Address - Zip Code:49017-4860
Practice Address - Country:US
Practice Address - Phone:269-578-3454
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2023-11-21
Last Update Date:2023-11-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes320800000XResidential Treatment FacilitiesCommunity Based Residential Treatment Facility, Mental Illness