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General NPI Number Information
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NPI Number | 1407119670
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Entity Type | Organization
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Legal Business Name | RYLIST INC
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Dates
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Enumeration Date | 06/21/2012
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Last Update Date | 12/02/2024
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Provider Practice Location Address
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Address Line | 155 E WILBUR RD
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City | THOUSAND OAKS
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State | CA
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Zip | 91360-7935
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Country | US
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Telephone | 833-239-3552
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Fax |
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Provider Business Mailing Address
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Address Line | 155 E WILBUR RD
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City | THOUSAND OAKS
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State | CA
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Zip | 91360-7935
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Country | US
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Telephone | 833-239-3552
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Fax | 805-777-9226
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Authorized Official
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Title or Position | OWNER/PRESIDENT
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Name | STEVE ZAMARRIPA
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Credential | CEO
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Telephone | 818-584-5615
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 261QM0850X
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Taxonomy Name | Adult Mental Health Clinic/Center
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License Number | LIC-7-11-3494
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License Number State | CA
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Taxonomy #2
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Taxonomy Code | 261QR0405X
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Taxonomy Name | Substance Use Disorder Rehabilitation Clinic/Center
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License Number | LIC-7-11-3494
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License Number State | CA
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