Provider Demographics
NPI:1831533918
Name:RYLIST
Entity type:Organization
Organization Name:RYLIST
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:CEO
Authorized Official - Prefix:MR
Authorized Official - First Name:STEVE
Authorized Official - Middle Name:
Authorized Official - Last Name:ZAMARIPPA
Authorized Official - Suffix:
Authorized Official - Credentials:CEO
Authorized Official - Phone:805-777-3873
Mailing Address - Street 1:275 E HILLCREST DR
Mailing Address - Street 2:SUITE 120
Mailing Address - City:THOUSAND OAKS
Mailing Address - State:CA
Mailing Address - Zip Code:91360-5827
Mailing Address - Country:US
Mailing Address - Phone:800-560-8518
Mailing Address - Fax:805-777-9226
Practice Address - Street 1:597 KALINDA PL
Practice Address - Street 2:
Practice Address - City:THOUSAND OAKS
Practice Address - State:CA
Practice Address - Zip Code:91320-2739
Practice Address - Country:US
Practice Address - Phone:805-777-3873
Practice Address - Fax:805-777-3874
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2013-04-19
Last Update Date:2014-01-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA550002229323P00000X
323P00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes323P00000XResidential Treatment FacilitiesPsychiatric Residential Treatment Facility