Ivy Harris

NPI #1073926812 in Grovetown, Georgia

Provider Information

NPI Number: 1073926812
Entity Type: Individual
Name: Ivy Harris
Gender: Not Specified
Sole Proprietor: Yes
Primary Specialty: Residential Treatment Facility, Intellectual and/or Developmental Disabilities
Enumeration Date: Jun 10, 2014
Last Updated: Jun 10, 2014

Practice Location

Address: 4613 MARTHAS WAY
City: Grovetown
State: Georgia
ZIP Code: 30813-2205
Phone: (732) 962-5450

Specialties & Taxonomy Codes

Specialty	Taxonomy Code	Primary
Residential Treatment Facility, Intellectual and/or Developmental Disabilities	320600000X	Primary

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