Organization
ARYSA LLC
Active
Other names
ALPINE ICF
Organization subpart
No
Provider details
NPI number
Authorized official
LUZ MARCOS (OWNER/ADMINISTRATOR)
(209) 598-1186
Entity
Organization
Contact information
Practice address
2216 ALPINE DR, LODI, CA 95240-6703
(209) 275-4065
(209) 339-1917
Mailing address
3432 GRANITE CT, STOCKTON, CA 95212-3406
(209) 598-1186
Taxonomy
Speciality
Code
Description
License number
State
310500000X
Mental Illness Intermediate Care Facility
Primary
—
—
Other
Enumeration date
08/09/2024
Last updated
08/09/2024
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