Provider Demographics
NPI:1508035106
Name:RYLIST, INC.
Entity Type:Organization
Organization Name:RYLIST, INC.
Other - Org Name:LA VENTANA EATING DISORDER PROGRAMS
Other - Org Type:Doing Business As
Authorized Official - Title/Position:OWNER/PRESIDENT
Authorized Official - Prefix:MR
Authorized Official - First Name:STEVE
Authorized Official - Middle Name:JOHN
Authorized Official - Last Name:ZAMARRIPA
Authorized Official - Suffix:
Authorized Official - Credentials:CEO
Authorized Official - Phone:818-584-5615
Mailing Address - Street 1:31341 MULHOLLAND HWY
Mailing Address - Street 2:
Mailing Address - City:MALIBU
Mailing Address - State:CA
Mailing Address - Zip Code:90265-2770
Mailing Address - Country:US
Mailing Address - Phone:818-584-0071
Mailing Address - Fax:818-584-0072
Practice Address - Street 1:275 E HILLCREST DRIVE
Practice Address - Street 2:SUITE #120
Practice Address - City:THOUSAND OAKS
Practice Address - State:CA
Practice Address - Zip Code:91360-5827
Practice Address - Country:US
Practice Address - Phone:805-777-3873
Practice Address - Fax:805-777-3874
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:RYLIST, INC.
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2008-02-27
Last Update Date:2013-04-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QM0850XAmbulatory Health Care FacilitiesClinic/CenterAdult Mental Health