Ricca

Primary specialty

Substance Use Disorder Rehabilitation Clinic/CenterTaxonomy code 261QR0405X

Legal business name

RICCA

Practice address

1607 John Deere Rd
East Moline, IL 61244-9662

Phone

(309) 792-0292

Fax

(309) 792-1121

NPI assigned

Mar 28, 2007

Last updated

Jul 17, 2017By the provider in NPPES

Organization subpart

No

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name

Mary J. Engholm, CADC, CAMS II

Title

Executive Director

Phone

(309) 792-0292

Specialties & licenses 3

Addresses

Other names 1

• Rock Island County Council on Addictions Former legal business name

Locations

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

• Kenneth Warren, CADC, CODP I

  • Addiction (Substance Use Disorder) Counselor
  • East Moline, IL
  • NPI 1114757218
  NPD (past)

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1175040000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1500249600000",
    "number": "1639298706",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1607 JOHN DEERE RD",
            "city": "EAST MOLINE",
            "state": "IL",
            "postal_code": "612449662",
            "telephone_number": "309-792-0292",
            "fax_number": "309-792-1121"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1607 JOHN DEERE RD",
            "city": "EAST MOLINE",
            "state": "IL",
            "postal_code": "612449662",
            "telephone_number": "309-792-0292",
            "fax_number": "309-792-1121"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "RICCA",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-03-28",
        "last_updated": "2017-07-17",
        "status": "A",
        "authorized_official_last_name": "ENGHOLM",
        "authorized_official_first_name": "MARY",
        "authorized_official_middle_name": "J.",
        "authorized_official_title_or_position": "EXECUTIVE DIRECTOR",
        "authorized_official_telephone_number": "309-792-0292",
        "authorized_official_credential": "CADC, CAMS II"
    },
    "taxonomies": [
        {
            "code": "251V00000X",
            "taxonomy_group": "",
            "desc": "Voluntary or Charitable",
            "state": "NU",
            "license": null,
            "primary": false
        },
        {
            "code": "261QR0405X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Rehabilitation, Substance Use Disorder",
            "state": "IL",
            "license": "A-0625-0004-A",
            "primary": false
        },
        {
            "code": "261QR0405X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Rehabilitation, Substance Use Disorder",
            "state": "IL",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Rock Island County Council on Addictions",
            "code": "4",
            "type": "Former Legal Business Name"
        }
    ]
}

• Randall T Ramsey, D.C.
• Anuradha Ranganath, M.D.
• Sudha Anand Reddy, DMD
• Respect Abilities, Inc.
• Jill Marie Reynolds, CCC-SLP
• Olivia Rice
• Jody Ricketts
• Riverwood Rehab, LLC (Aperion Care Moline)
• Hope Roberts
• Amber Rogers

• Substance Use Disorder Rehabilitation Clinic/Center in East Moline, IL
• Providers in East Moline, IL by specialty
• Substance Use Disorder Rehabilitation Clinic/Center in Illinois

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 17, 2017; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.