IVY TERRACE AT GAMBRILL GARDENS III NPI 1487995254

NPI Information

NPI: 1487995254
Provider Name: IVY TERRACE AT GAMBRILL GARDENS III

Doing Business As: IVY TERRACE

Classification: Assisted Living Facility - 310400000X
Entity Type: Organization
Address:
1 STRECKER RD
ELLISVILLE, MO
ZIP 63011
Phone: (636) 394-2992
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IVY TERRACE AT GAMBRILL GARDENS III is an assisted living facility in Ellisville, MO. The provider is 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. IVY TERRACE AT GAMBRILL GARDENS III NPI is 1487995254. The provider is registered as an organization entity type.
The provider Is Doing Business As Ivy Terrace.

The provider's business location address is:

1 STRECKER RD
ELLISVILLE, MO
ZIP 63011-998
Phone: (636) 394-2992

The provider's authorized official is Mary Jane Harris .
The authorized official title is Executive Director and has the following contact phone number (636) 394-2992.

The enumeration date for this NPI number is 3/4/2013 and was last updated on 3/4/2013.

Taxonomy Codes

The NPI record includes the healthcare provider taxonomy classification, state license number and state of licensure. The following information regarding the scope of practice of this provider is available:

No.	Taxonomy Code	Taxonomy Clasification	Taxonomy Specialization	License Number	License State	Primary
1	310400000X	Assisted Living Facility		040294	MISSOURI	Yes

What is NPI?

NPI stands for National Provider Identifier. The NPI is a 10-digit identification number that is completely unique. The NPI number by itself does not contain any identifiable information such as a provider’s speciality or location. The NPI is assigned to individuals or organizacions for their lifespan and it is independent of key provider information type updates like a change of practices, location or speciality.

This page was last updated on: 5/5/2024

NPI Synchronization or Removal

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