Iveyhouse Ltd.

NPI #1770988123 in Petersburg, Virginia

Provider Information

NPI Number: 1770988123
Entity Type: Organization
Organization Name: Iveyhouse Ltd.
Primary Specialty: Community Based Residential Treatment Facility, Intellectual and/or Developmental Disabilities
Enumeration Date: Oct 28, 2014
Last Updated: Oct 28, 2014

Practice Location

Address: 2222 COLSTON ST
City: Petersburg
State: Virginia
ZIP Code: 23805-2204
Phone: (804) 835-9137

Authorized Official

Name: JEFFREY EDWARD LINDSTOM
Title: CEO
Phone: (804) 382-3741

Specialties & Taxonomy Codes

Specialty	Taxonomy Code	Primary
Community Based Residential Treatment Facility, Intellectual and/or Developmental Disabilities	320900000X	Primary

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