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Ivy Harris
Intellectual and/or Developmental Disabilities Residential Treatment Facility in Grovetown, Georgia
NPI 1073926812

Ivy Harris is a Intellectual and/or Developmental Disabilities Residential Treatment Facility based in Grovetown, GA. Ivy Harris practices in Grovetown, GA. The NPI Number for Ivy Harris is 1073926812 and holds a License No. (Georgia).

The current practice location address for Ivy Harris is 4613 Marthas Way, Grovetown, GA and can be reached out via phone at 732-962-5450.

Location: 4613 Marthas Way, Grovetown, GA, 30813
Profile Details Legacy Identifiers Practice Address Mailing Address Primary Taxonomy
person
Provider Profile Details
NPI Number
1073926812
Provider Name
Ivy Harris
Credential
Provider Entity Type
Individual
Gender
Female
Address
4613 Marthas Way, Grovetown, GA, 30813
Phone Number
732-962-5450
Fax Number
Provider Enumeration Date
06/10/2014
Last Update Date
03/09/2024
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Provider's Legacy Identifiers
Identifier Type State Issuer
000606317B 05 GA
institution
Provider Business Practice Location Address Details
Address
4613 Marthas Way
City
Grovetown
State
Georgia
Zip
30813-2205
Phone Number
732-962-5450
Fax Number
person
Provider Business Mailing Address Details
Address
4613 Marthas Way
City
Grovetown
State
Georgia
Zip
30813-2205
Phone Number
732-962-5450
Fax Number
person
Provider's Taxonomy Details 1
Type
Residential Treatment Facilities
Classification
Residential Treatment Facility, Intellectual and/or Developmental Disabilities
Speciality
-
Taxonomy
320600000X
License No.
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Definition
A residential facility that provides habilitation services and other care and treatment to adults or children diagnosed with developmental and intellectual disabilities and are not able to live independently.
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