Organization
ARYSA, LLC
Active
Other names
Sunshine ICF, DDN
Organization subpart
No
Provider details
NPI number
Authorized official
LUZ MARCOS (OWNER/LICENSEE/ADMINISTRATOR)
(209) 598-1186
Entity
Organization
Contact information
Practice address
1701 W. ELM ST., LODI, CA 95242
(209) 263-7196
Mailing address
3432 GRANITE CT., STOCKTON, CA 95212
(209) 598-1186
(415) 634-1755
Taxonomy
Speciality
Code
Description
License number
State
320900000X
Intellectual and/or Developmental Disabilities Community Based Residential Treatment Facility
Primary
55GP1907
CA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
55GP1907
MEDI-CAL PROVIDER
CA
Enumeration date
03/25/2010
Last updated
12/16/2025
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