Provider Demographics
NPI:1073789129
Name:RYAN AND RYAN
Entity Type:Organization
Organization Name:RYAN AND RYAN
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:DIRECTOR
Authorized Official - Prefix:
Authorized Official - First Name:MARY
Authorized Official - Middle Name:BETH
Authorized Official - Last Name:RYAN
Authorized Official - Suffix:
Authorized Official - Credentials:BS,NCACII,ICACII
Authorized Official - Phone:219-866-3331
Mailing Address - Street 1:110 W WASHINGTON ST
Mailing Address - Street 2:SUITE 9
Mailing Address - City:RENSSELAER
Mailing Address - State:IN
Mailing Address - Zip Code:47978-2820
Mailing Address - Country:US
Mailing Address - Phone:219-866-3331
Mailing Address - Fax:219-866-3451
Practice Address - Street 1:110 W WASHINGTON ST
Practice Address - Street 2:SUITE 9
Practice Address - City:RENSSELAER
Practice Address - State:IN
Practice Address - Zip Code:47978-2820
Practice Address - Country:US
Practice Address - Phone:219-866-3331
Practice Address - Fax:219-866-3451
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2008-05-07
Last Update Date:2008-05-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251S00000XAgenciesCommunity/Behavioral Health
No251B00000XAgenciesCase Management