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Ivy Creek Of Tallapoosa Llc
Rural Health Clinic/Center in Dadeville, Alabama
NPI 1932130002

Ivy Creek Of Tallapoosa Llc is a Rural Health Clinic/Center based in Dadeville, AL and is specialized in Rural Health. Ivy Creek Of Tallapoosa Llc practices in Dadeville, AL. The NPI Number for Ivy Creek Of Tallapoosa Llc is 1932130002 and holds a License No. (Alabama).

The current practice location address for Ivy Creek Of Tallapoosa Llc is 301 Mariarden Rd, Dadeville, AL and can be reached out via phone at 256-825-7871 and via fax at 256-825-5742.

Location: 301 Mariarden Rd, Dadeville, AL, 36853-0129
Profile Details Legacy Identifiers Practice Address Mailing Address Primary Taxonomy
institution
Provider Profile Details
NPI Number
1932130002
Provider Name
Ivy Creek Of Tallapoosa Llc
Credential
Provider Entity Type
Organization
Address
301 Mariarden Rd, Dadeville, AL, 36853-0129
Phone Number
256-825-7871
Fax Number
256-825-5742
Provider Enumeration Date
07/06/2006
Last Update Date
03/08/2024
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Provider's Legacy Identifiers
Identifier Type State Issuer
540003420 05 AL
01D0920584 01 AL CLIA
institution
Provider Business Practice Location Address Details
Address
301 Mariarden Rd
City
Dadeville
State
Alabama
Zip
36853-0129
Phone Number
256-825-7871
Fax Number
256-825-5742
person
Provider Business Mailing Address Details
Address
301 Mariarden Rd
City
Dadeville
State
Alabama
Zip
36853-0129
Phone Number
256-825-7871
Fax Number
256-825-5742
person
Provider's Taxonomy Details 1
Type
Ambulatory Health Care Facilities
Classification
Clinic/Center
Speciality
Rural Health
Taxonomy
261QR1300X
License No.
()
Definition
Definition to come...
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