Healthcare Provider Details

I. General information

NPI: 1063289189
Provider Name (Legal Business Name): RYS WELLNESS
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 12/08/2023
Last Update Date: 12/08/2023
Certification Date: 12/08/2023
Deactivation Date:
Reactivation Date:

III. Provider practice location address

4237 SALISBURY RD
JACKSONVILLE FL
32216-8029
US

IV. Provider business mailing address

10075 GATE PKWY N 1101
JACKSONVILLE FL
32246
US

V. Phone/Fax

Practice location:
  • Phone: 904-749-4492
  • Fax:
Mailing address:
  • Phone: 904-749-4492
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code251E00000X
TaxonomyHome Health Agency
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code251S00000X
TaxonomyCommunity/Behavioral Health Agency
License Number
License Number State

VIII. Authorized Official

Name: RANSLAH HURST
Title or Position: CEO
Credential:
Phone: 904-749-4492