| Organization Name: | IVY CREEK OF TALLAPOOSA |
| NPI Number: | 1811169857 |
| Entity Type Code: | Organizational (2) |
| Authorized Official Name: | CAROLINE MORRIS (BUSINESS OFFICE MANAGER) |
| Mailing Address: | 201 Mariarden Rd Dadeville |
| State: | AL US |
| Postal Code: | 368536244 |
| Phone Number: | 2568257821 |
| Fax Number: | |
| NPI Enumeration Date: | 03/31/2008 |
| NPI Last Update Date: | 03/31/2008 |
| Replacement NPI: | 0 |
| NPI Deactivation Date: | |
| NPI Reactivation Date: |
Taxonomy Information: | |
| Healthcare Provider Taxonomy: | 146N00000X |
| License Number: | 0712 |
| Healthcare Provider Taxonomy: (Secondary) | Y |
| State: | AL |
| Taxonomy Type: | Emergency Medical Service Providers |
| Taxonomy Classification: | Emergency Medical Technician, Basic |
| Taxonomy Specialization: | |
| Taxonomy Definition: | A Basic EMT is an individual trained and certified to perform basic life support treatment in medical emergencies based on individual state boards. |