MEDICARE: RIAN RYELEE FOUNDATION INC

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy
1	251K00000X	Public Health or Welfare Agency
2	251S00000X	Community/Behavioral Health Agency
3	251V00000X	Voluntary or Charitable Agency
4	261QP0905X	State or Local Public Health Clinic/Center
5	385HR2055X	Child Mental Illness Respite Care
6	101YM0800X	Mental Health Counselor
7	171M00000X	Case Manager/Care Coordinator
8	171W00000X	Contractor
9	172V00000X	Community Health Worker
10	225C00000X	Rehabilitation Counselor
11	405300000X	Prevention Professional
12	251B00000X	Case Management Agency

General Provider Information

NPI Number	:	1659105799
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	RIAN RYELEE FOUNDATION INC

Provider Business Mailing Address
First Line	:	PO BOX 90061
Second Line	:
City	:	EAST POINT
State	:	GA
Zip	:	30364-0061
Country	:	US
Telephone Number	:
Fax Number	:

Provider Business Practice Location Address
First Line	:	5931 GREENVILLE AVE # 1102
Second Line	:
City	:	DALLAS
State	:	TX
Zip	:	75206-1906
Country	:	US
Telephone Number	:	312-450-0857
Fax Number	:

Authorized Official
Title or Position	:	EXECUTIVE DIRECTOR
Name	:	MS. RIAN GRAHAM
Credential	:
Telephone Number	:	248-657-0826

Provider Enumeration Date	:	08/30/2024
Last Update Date	:	09/25/2024

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Directions to “RIAN RYELEE FOUNDATION INC ” Practice Location

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