Organization Name: | IVY CREEK OF TALLAPOOSA |
NPI Number: | 1659685345 |
Entity Type Code: | Organizational (2) |
Authorized Official Name: | MICHAEL BRUCE (OWNER/CEO) |
Mailing Address: | 201 Mariarden Rd Dadeville |
State: | AL US |
Postal Code: | 368536244 |
Phone Number: | 2568257821 |
Fax Number: | |
NPI Enumeration Date: | 08/05/2010 |
NPI Last Update Date: | 08/05/2010 |
Replacement NPI: | 0 |
NPI Deactivation Date: | |
NPI Reactivation Date: |
Taxonomy Information: | |
Healthcare Provider Taxonomy: | 275N00000X |
License Number: | H6202 |
Healthcare Provider Taxonomy: (Secondary) | Y |
State: | AL |
Taxonomy Type: | Hospital Units |
Taxonomy Classification: | Medicare Defined Swing Bed Unit |
Taxonomy Specialization: | |
Taxonomy Definition: | A unit of a hospital that has a Medicare provider agreement and has been granted approval from HCFA to provide post-hospital extended care services and be reimbursed as a swing-bed unit. |