Healthcare Provider Details

I. General information

NPI: 1326424607
Provider Name (Legal Business Name): RYLIST INC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 08/10/2015
Last Update Date: 08/17/2021
Certification Date: 08/17/2021
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1771 COUNTRY OAKS LN
THOUSAND OAKS CA
91362-1922
US

IV. Provider business mailing address

1408 E THOUSAND OAKS BLVD STE 100
THOUSAND OAKS CA
91362-2889
US

V. Phone/Fax

Practice location:
  • Phone: 805-777-3873
  • Fax: 805-777-9226
Mailing address:
  • Phone: 833-239-3552
  • Fax: 805-777-9226

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code324500000X
TaxonomySubstance Abuse Rehabilitation Facility
License Number
License Number State

VIII. Authorized Official

Name: JULIE LOVIER
Title or Position: BILLING MANAGER
Credential:
Phone: 805-852-1267