Organization
ARYSA, LLC
Active
Other names
Gabriel ICF
Organization subpart
No
Provider details
NPI number
Authorized official
LUZ MARCOS (OWNER/LICENSEE/ ADMINISTRATOR)
(209) 598-1186
Entity
Organization
Contact information
Practice address
2155 W. ELM ST., LODI, CA 95242
(209) 333-1904
(209) 368-2771
Mailing address
3432 GRANITE CT., STOCKTON, CA 95212
(209) 598-1186
(415) 634-1755
Taxonomy
Speciality
Code
Description
License number
State
315P00000X
Intellectual Disabilities Intermediate Care Facility
Primary
LTC80160F
CA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
LTC80160F
—
CA
Enumeration date
01/12/2007
Last updated
12/16/2025
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