Provider Demographics
NPI:1891193538
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:BILLING MANAGER
Authorized Official - Prefix:
Authorized Official - First Name:JULIE
Authorized Official - Middle Name:
Authorized Official - Last Name:LOVIER
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:805-852-1267
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:
Practice Address - Street 1:1154 CARDIFF CIR
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:805-379-4883
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2014-12-11
Last Update Date:2021-08-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA560038GP324500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes324500000XResidential Treatment FacilitiesSubstance Abuse Rehabilitation Facility