Ivy Creek Family Care Of Holtville

LBN: Ivy Creek Of Elmore, Llc
Ivy Creek Family Care Of Holtville is an health care organization with primary practice located at 4412 Hogan Rd , Deatsville AL 36022-3400. The organization recently has only one registered license in Ambulatory Health Care Facilities / Rural Health, which is considered as the primary health care specialty. Ivy Creek Of Elmore, Llc can be contacted via phone (334) 514-4851, or through Bruce, Michael D via phone (334) 567-4311.

Contact Information

Primary practice address
4412 Hogan Rd Deatsville AL 36022-3400
Phone: (334) 514-4851
Fax: (334) 543-4854
Website:
Map and Directions
Authorized official contact:
Name: Bruce, Michael D
Phone: (334) 567-4311

Health care specialties

SpecialtyCodeLicense #State
Ambulatory Health Care Facilities / Rural Health 261QR1300X

Profile Details

NPI number 1578060349
LBN Legal business name Ivy Creek Of Elmore, Llc
DBA Doing business as Ivy Creek Family Care Of Holtville
Authorized official Bruce, Michael D
Entity Organization
Organization subpart 1 No
Enumeration date Apr 9th, 2018
Last updated Apr 5th, 2022 - about 2 years ago

1 Some organizations, which are providing health care services, may consist of units or departments that provide different types of health care services or have several separate physical locations, where health care service is provided. These units, departments or physical locations are not themselves legal entities. However, each of them is part of the organization, which is a legal entity. The organization may decide whether its subparts, if it has any, should have their own NPI numbers. In case a subpart conducts any HIPAA standard transactions by itself, without its parent's involvement, it must have its own NPI number.

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Identifiers

StateTypeNumberIssuer
All States NPI 1578060349 NPPES
Alabama Other 01D2153925 CLIA
Alabama Other 1608 CLIA
Alabama MEDICAID 231138 CLIA
Alabama Other 13474 CLIA

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