Ivory Assisted Living, LLC

Primary specialty

Assisted Living FacilityTaxonomy code 310400000X

License

23M119 Issued in CO

Legal business name

IVORY ASSISTED LIVING, LLC

Practice address

4633 S Ivory Cir
Aurora, CO 80015-1407

Phone

(303) 690-4150

Fax

(303) 690-4150

NPI assigned

Sep 17, 2015

Organization subpart

No

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name

Mr. Joseph Lee

Title

Administrator

Phone

(303) 690-4150

Specialties & licenses 1

Addresses

Other identifiers 1

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1442448000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1442448000000",
    "number": "1184093346",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4633 S IVORY CIR",
            "city": "AURORA",
            "state": "CO",
            "postal_code": "800151407",
            "telephone_number": "303-690-4150",
            "fax_number": "303-690-4150"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4633 S IVORY CIR",
            "city": "AURORA",
            "state": "CO",
            "postal_code": "800151407",
            "telephone_number": "303-690-4150",
            "fax_number": "303-690-4150"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "IVORY ASSISTED LIVING, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2015-09-17",
        "last_updated": "2015-09-17",
        "status": "A",
        "authorized_official_last_name": "LEE",
        "authorized_official_first_name": "JOSEPH",
        "authorized_official_title_or_position": "ADMINISTRATOR",
        "authorized_official_telephone_number": "303-690-4150",
        "authorized_official_name_prefix": "Mr."
    },
    "taxonomies": [
        {
            "code": "310400000X",
            "taxonomy_group": "",
            "desc": "Assisted Living Facility",
            "state": "CO",
            "license": "23M119",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "80456278",
            "state": "CO"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Tommy Ivanics, M.D.
• Mary Elizabeth Iversen, MSW
• Emily Marie Iverson
• Laurie C Ivey, PSYD
• Connor Ivnoff
• David Ivy, MD
• Zaccariah Desmond Ivy, PA
• Sean J Iwamoto, MD
• Masayo Iwate, LCSW
• Lauretta Iwuala -McWilliams, NP-C

• Assisted Living Facility in Aurora, CO
• Providers in Aurora, CO by specialty
• Assisted Living Facility in Colorado

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 17, 2015; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.