Provider Demographics
NPI:1457821100
Name:RYLANS WAY INCORPORATED
Entity Type:Organization
Organization Name:RYLANS WAY INCORPORATED
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:JADE
Authorized Official - Middle Name:MARIE
Authorized Official - Last Name:NIMMO
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:786-909-9029
Mailing Address - Street 1:494 CLERMONT AVE S
Mailing Address - Street 2:
Mailing Address - City:ORANGE PARK
Mailing Address - State:FL
Mailing Address - Zip Code:32073-4337
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:494 CLERMONT AVE S
Practice Address - Street 2:
Practice Address - City:ORANGE PARK
Practice Address - State:FL
Practice Address - Zip Code:32073-4337
Practice Address - Country:US
Practice Address - Phone:786-909-9029
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2018-11-26
Last Update Date:2018-11-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251C00000XAgenciesDay Training, Developmentally Disabled Services
Provider Identifiers
StateIdentifier IDID TypeIssuer
FL730396Medicaid