Ivy House Assisted Living, LLC

Primary specialty

Assisted Living FacilityTaxonomy code 310400000X

License

0080R Issued in OH

Legal business name

IVY HOUSE ASSISTED LIVING, LLC

Practice address

308 S State St
Painesville, OH 44077-3532

Phone

(440) 354-2131

Fax

(440) 354-2068

NPI assigned

Jul 28, 2008

Organization subpart

No

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

Authorized official

Name

Mrs. Michelle M Gil

Title

Administrator

Phone

(440) 354-2131

Specialties & licenses 1

Addresses

Locations

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

{
    "created_epoch": "1217203200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1217203200000",
    "number": "1255596359",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "308 S STATE ST",
            "city": "PAINESVILLE",
            "state": "OH",
            "postal_code": "440773532",
            "telephone_number": "440-354-2131",
            "fax_number": "440-354-2068"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "308 S STATE ST",
            "city": "PAINESVILLE",
            "state": "OH",
            "postal_code": "440773532",
            "telephone_number": "440-354-2131",
            "fax_number": "440-354-2068"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "IVY HOUSE ASSISTED LIVING, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2008-07-28",
        "last_updated": "2008-07-28",
        "status": "A",
        "authorized_official_last_name": "GIL",
        "authorized_official_first_name": "MICHELLE",
        "authorized_official_middle_name": "M",
        "authorized_official_title_or_position": "ADMINISTRATOR",
        "authorized_official_telephone_number": "440-354-2131",
        "authorized_official_name_prefix": "Mrs."
    },
    "taxonomies": [
        {
            "code": "310400000X",
            "taxonomy_group": "",
            "desc": "Assisted Living Facility",
            "state": "OH",
            "license": "0080R",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Seema Jayram Ice, M.D.
• Linda N Imondi, OTR
• Inspire Wellness & Nutrition, LLC
• Interactive Health Solutions
• Sharon Ivaskovic
• Amirah Jackson
• Delmesha Jackson
• Dolores Jacksonwilliams
• Stacey Marie Jansen, CRNA
• Tiara Jefferies

• Assisted Living Facility in Painesville, OH
• Providers in Painesville, OH by specialty
• Assisted Living Facility in Ohio

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 28, 2008; 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.