Provider Demographics
NPI:1407119670
Name:RYLIST INC
Entity Type:Organization
Organization Name:RYLIST INC
Other - Org Name:LA VENTANA TREATMENT PROGRAMS
Other - Org Type:Doing Business As
Authorized Official - Title/Position:OWNER/PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:STEVE
Authorized Official - Middle Name:
Authorized Official - Last Name:ZAMARRIPA
Authorized Official - Suffix:
Authorized Official - Credentials:CEO
Authorized Official - Phone:818-584-5615
Mailing Address - Street 1:1408 E THOUSAND OAKS BLVD
Mailing Address - Street 2:
Mailing Address - City:THOUSAND OAKS
Mailing Address - State:CA
Mailing Address - Zip Code:91362-2889
Mailing Address - Country:US
Mailing Address - Phone:833-239-3552
Mailing Address - Fax:805-777-9226
Practice Address - Street 1:1408 E THOUSAND OAKS BLVD
Practice Address - Street 2:
Practice Address - City:THOUSAND OAKS
Practice Address - State:CA
Practice Address - Zip Code:91362
Practice Address - Country:US
Practice Address - Phone:833-239-3552
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:RYLIST
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2012-06-21
Last Update Date:2021-08-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CALIC-7-11-3494261QM0850X, 261QR0405X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QR0405XAmbulatory Health Care FacilitiesClinic/CenterRehabilitation, Substance Use Disorder
No261QM0850XAmbulatory Health Care FacilitiesClinic/CenterAdult Mental Health