=====================================================
General NPI Number Information
=====================================================
NPI Number | 1528303682
-----------------------------------------------------
Entity Type | Organization
-----------------------------------------------------
Legal Business Name | RYLIST,INC
-----------------------------------------------------
=====================================================
Dates
=====================================================
Enumeration Date | 11/30/2012
-----------------------------------------------------
Last Update Date | 12/02/2024
-----------------------------------------------------
=====================================================
Provider Practice Location Address
=====================================================
Address Line | 385 N CONEJO SCHOOL RD
-----------------------------------------------------
City | THOUSAND OAKS
-----------------------------------------------------
State | CA
-----------------------------------------------------
Zip | 91362
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 805-379-0565
-----------------------------------------------------
Fax |
-----------------------------------------------------
=====================================================
Provider Business Mailing Address
=====================================================
Address Line | 155 E WILBUR RD
-----------------------------------------------------
City | THOUSAND OAKS
-----------------------------------------------------
State | CA
-----------------------------------------------------
Zip | 91360-7935
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 800-560-8518
-----------------------------------------------------
Fax | 805-777-9226
-----------------------------------------------------
=====================================================
Authorized Official
=====================================================
Title or Position | OWNER PRESIDENT
-----------------------------------------------------
Name | MR. STEVE ZAMARRPIA
-----------------------------------------------------
Credential | CEO
-----------------------------------------------------
Telephone | 818-584-5615
-----------------------------------------------------
=====================================================
Scope of Practice (Provider's specialty)
=====================================================
Taxonomy #1
-----------------------------------------------------
Taxonomy Code | 324500000X
-----------------------------------------------------
Taxonomy Name | Substance Abuse Rehabilitation Facility
-----------------------------------------------------
License Number | 560038DP
-----------------------------------------------------
License Number State | CA
-----------------------------------------------------