Data from the NPPES registry. May not reflect recent changes — verify at nppes.cms.hhs.gov.
IVY HARRIS
Active Sole ProprietorIntellectual Disabilities Residential Treatment Facility · GROVETOWN, GA
Registration Details
- NPI Number
- 1073926812
- Provider Type
- Individual
- Gender
- Female
- NPI Issued
- Jun 10, 2014 (11.864880509132 yrs)
- Last Updated
- Jun 10, 2014
- Sole Proprietor
- Yes
Practice Information
- Address
-
4613 MARTHAS WAYGROVETOWN, GA, 308132205Browse GA providers · Browse ZIP 30813
- Phone
- 7329625450
- Primary Specialty
-
Intellectual Disabilities Residential Treatment Facility
320600000X
Data sourced from the NPPES National Provider Identifier registry. This information is for informational purposes only and is not a substitute for verifying credentials with the appropriate licensing authority. For official verification, use the NPPES NPI Registry or the relevant state medical board.