Provider Demographics
NPI:1588412431
Name:RYRA INCORPORATED
Entity type:Organization
Organization Name:RYRA INCORPORATED
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:CEO
Authorized Official - Prefix:
Authorized Official - First Name:JAZS
Authorized Official - Middle Name:
Authorized Official - Last Name:LOVELACE
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:323-678-3874
Mailing Address - Street 1:10950 CHURCH ST
Mailing Address - Street 2:2522
Mailing Address - City:RANCHO CUCAMONGA
Mailing Address - State:CA
Mailing Address - Zip Code:91730-8084
Mailing Address - Country:US
Mailing Address - Phone:323-678-3874
Mailing Address - Fax:
Practice Address - Street 1:10950 CHURCH ST
Practice Address - Street 2:2522
Practice Address - City:RANCHO CUCAMONGA
Practice Address - State:CA
Practice Address - Zip Code:91730-8084
Practice Address - Country:US
Practice Address - Phone:323-678-3874
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2024-05-07
Last Update Date:2025-04-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes251S00000XAgenciesCommunity/Behavioral HealthGroup - Multi-Specialty
No251K00000XAgenciesPublic Health or Welfare
No251B00000XAgenciesCase Management
No261QC1500XAmbulatory Health Care FacilitiesClinic/CenterCommunity Health
No374J00000XNursing Service Related ProvidersDoulaGroup - Multi-Specialty