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General NPI Number Information
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NPI Number | 1013183581
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Entity Type | Organization
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Legal Business Name | ARYSA, LLC
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Dates
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Enumeration Date | 05/05/2008
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Last Update Date | 10/13/2025
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Provider Practice Location Address
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Address Line | 2216 ALPINE DRIVE
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City | LODI
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State | CA
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Zip | 95240-7223
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Country | US
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Telephone | 209-333-0592
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Fax | 209-368-2771
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Provider Business Mailing Address
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Address Line | 3432 GRANITE CT.
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City | STOCKTON
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State | CA
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Zip | 95212
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Country | US
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Telephone | 209-598-1186
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Fax | 415-634-1755
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Authorized Official
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Title or Position | OWNER/LICENSEE/ADMINISTRATOR
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Name | MS. LUZ MARCOS
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Credential | RN
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Telephone | 209-598-1186
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 315P00000X
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Taxonomy Name | Intellectual Disabilities Intermediate Care Facility
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License Number | LTC80271F
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License Number State | CA
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