Ivy Creek of Elmore, LLC
NPI #1578060349 in Deatsville, Alabama
Provider Information
- NPI Number
- 1578060349
- Entity Type
- Organization
- Organization Name
- Ivy Creek of Elmore, LLC
- Primary Specialty
- Clinic/Center - Rural Health
- Enumeration Date
- Apr 9, 2018
- Last Updated
- Mar 20, 2025
Practice Location
- Address
- 4412 HOGAN RD
- City
- Deatsville
- State
- Alabama
- ZIP Code
- 36022-3400
- Phone
- (334) 514-4851
Authorized Official
- Name
- MRS. JADE LANE
- Title
- CREDENTIALING MANAGER
- Phone
- (334) 567-4311
Specialties & Taxonomy Codes
| Specialty |
|---|
| Clinic/Center - Rural Health — Rural Health |
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