Healthcare Provider Details

I. General information

NPI: 1720630874
Provider Name (Legal Business Name): PRY, INC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 07/09/2019
Last Update Date: 11/13/2019
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

16200 VENTURA BLVD STE 309
ENCINO CA
91436-4671
US

IV. Provider business mailing address

16200 VENTURA BLVD STE 309
ENCINO CA
91436-4671
US

V. Phone/Fax

Practice location:
  • Phone: 818-486-2273
  • Fax:
Mailing address:
  • Phone: 818-486-2273
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code251G00000X
TaxonomyCommunity Based Hospice Care Agency
License Number
License Number State

VIII. Authorized Official

Name: REGINA STERIN
Title or Position: CEO
Credential:
Phone: 818-486-2273