Healthcare Provider Details

I. General information

NPI: 1174384853
Provider Name (Legal Business Name): RYZEARC LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 01/19/2024
Last Update Date: 01/23/2024
Certification Date: 01/23/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

168 N BEACON ST APT 1A
BRIGHTON MA
02135-2043
US

IV. Provider business mailing address

168 N BEACON ST APT 1A
BRIGHTON MA
02135-2043
US

V. Phone/Fax

Practice location:
  • Phone: 563-260-5872
  • Fax:
Mailing address:
  • Phone: 563-260-5872
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code253Z00000X
TaxonomyIn Home Supportive Care Agency
License Number
License Number State
# 2
Primary TaxonomyY
Taxonomy Code374J00000X
TaxonomyDoula
License Number
License Number State

VIII. Authorized Official

Name: ABRIANNA CANADY
Title or Position: MANAGER/OWNER
Credential: DOULA
Phone: 563-260-5872