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Ivydale At Willow Lodge
Assisted Living Facility in Moultrie, Georgia
NPI 1750766507

Ivydale At Willow Lodge is an Assisted Living Facility based in Moultrie, GA. Ivydale At Willow Lodge practices in Moultrie, GA. The NPI Number for Ivydale At Willow Lodge is 1750766507 and holds a License No. PCH008684 (Georgia).

The current practice location address for Ivydale At Willow Lodge is 3120 S Main St, Moultrie, GA and can be reached out via phone at 229-668-4721.

Location: 3120 S Main St, Moultrie, GA, 31768-6702
Profile Details Legacy Identifiers Practice Address Mailing Address Primary Taxonomy
institution
Provider Profile Details
NPI Number
1750766507
Provider Name
Ivydale At Willow Lodge
Credential
Provider Entity Type
Organization
Address
3120 S Main St, Moultrie, GA, 31768-6702
Phone Number
229-668-4721
Fax Number
Provider Enumeration Date
07/22/2015
Last Update Date
03/09/2024
institution
Provider Business Practice Location Address Details
Address
3120 S Main St
City
Moultrie
State
Georgia
Zip
31768-6702
Phone Number
229-668-4721
Fax Number
person
Provider Business Mailing Address Details
Address
3120 S Main St
City
Moultrie
State
Georgia
Zip
31768-6702
Phone Number
229-668-4721
Fax Number
person
Provider's Taxonomy Details 1
Type
Nursing & Custodial Care Facilities
Classification
Assisted Living Facility
Speciality
-
Taxonomy
310400000X
License No.
PCH008684 (Georgia)
Definition
A facility providing supportive services to individuals who can function independently in most areas of activity, but need assistance and/or monitoring to assure safety and well being.
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