IVY CREEK OF ELMORE, LLC

WETUMPKA, AL
NPI1093838880
Entity TypeOrganization
Authorized ContactGORDON FAULK
CEO
334-567-4311
Organization Subpart ?No
Primary Taxonomy305R00000X Preferred Provider Organization
(Licence: AL  00011939)
Enumeration Date2007-04-09
Last Update Date2020-08-22
Business Address
IVY CREEK OF ELMORE, LLC
74186 TALLASSEE HWY
WETUMPKA, AL 36092-5643
Phone number: 334-567-0346
Mailing Address
IVY CREEK OF ELMORE, LLC
500 HOSPITAL DR
WETUMPKA, AL 36092-1625
Phone number: 334-567-4311