Lookup NPI Numbers from the NPI Registry
Specialty |
Taxonomy Code | Specialty Code | Provider Type | |
Rural Health |
261QR1300X | B4[14] | Rural Health Clinic | |
Preferred Provider Organization |
305R00000X |
| NPI # | 1366565152 |
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| LBN Legal business name | IVYCREEK OF ELMORE LLC | ||||||||
| Authorized official | MICHAEL BRUCE - (CEO) | ||||||||
| Entity | Organization | ||||||||
| Organization subpart 1 | Yes | ||||||||
| Enumeration date | 04/09/2007 | ||||||||
| Last updated | 10/01/2012 - About 14 years ago | ||||||||
| Identifiers |
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IVYCREEK OF ELMORE LLC
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IVYCREEK OF ELMORE LLC