Provider Demographics
NPI:1831405109
Name:V- RYAN MANAGEMENT, INC
Entity type:Organization
Organization Name:V- RYAN MANAGEMENT, INC
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:ADMINISTRATOR
Authorized Official - Prefix:
Authorized Official - First Name:YOLANDA
Authorized Official - Middle Name:
Authorized Official - Last Name:SMITH
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:770-649-9930
Mailing Address - Street 1:6065 ROSWELL RD NE
Mailing Address - Street 2:SUITE 424
Mailing Address - City:SANDY SPRINGS
Mailing Address - State:GA
Mailing Address - Zip Code:30328-4011
Mailing Address - Country:US
Mailing Address - Phone:770-649-9930
Mailing Address - Fax:770-645-8161
Practice Address - Street 1:6065 ROSWELL RD NE
Practice Address - Street 2:SUITE 424
Practice Address - City:SANDY SPRINGS
Practice Address - State:GA
Practice Address - Zip Code:30328-4011
Practice Address - Country:US
Practice Address - Phone:770-649-9930
Practice Address - Fax:770-645-8161
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2010-08-25
Last Update Date:2010-08-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
GA033-R-0083253Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes253Z00000XAgenciesIn Home Supportive Care
Provider Identifiers
StateIdentifier IDID TypeIssuer
GA192461923DMedicaid