| NPI | 1558868323 |
|---|---|
| Doing Business As | IVY CREEK FAMILY CARE OF TALLASSEE |
| Entity Type | Organization |
| Authorized Contact | JADE LANE Credentialing Manager 334-567-4311 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QR1300X Clinic/Center, Rural Health |
| Enumeration Date | 2018-04-09 |
| Last Update Date | 2025-03-20 |