Ivy Creek Prevention Center LLC

NPI #1659755577 in Dadeville, Alabama

Provider Information

NPI Number: 1659755577
Entity Type: Organization
Organization Name: Ivy Creek Prevention Center LLC
Primary Specialty: General Practice
Enumeration Date: Jul 10, 2015
Last Updated: May 19, 2016

Practice Location

Address: 2129 MOONBROOK DR
City: Dadeville
State: Alabama
ZIP Code: 36853-5640
Phone: (334) 514-3848

Authorized Official

Name: MICHAEL D BRUCE
Title: CEO
Phone: (256) 675-0412

Specialties & Taxonomy Codes

Specialty	Taxonomy Code	Primary
General Practice	208D00000X	Primary

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