Ivy Crest, Aclf

Primary specialty

Assisted Living FacilityTaxonomy code 310400000X

Legal business name

IVY CREST, ACLF

Practice address

101 Ivy Lane
Pulaski, TN 38478

Phone

(931) 363-3633

Fax

(931) 363-3686

NPI assigned

Jan 4, 2022

Organization subpart

No

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

Authorized official

Name

Cora Marie Pratt

Title

Administrator

Phone

(931) 363-3633

Specialties & licenses 1

Addresses

Locations

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

{
    "created_epoch": "1641254400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1641254400000",
    "number": "1487315255",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "101 IVY LANE",
            "city": "PULASKI",
            "state": "TN",
            "postal_code": "38478",
            "telephone_number": "931-363-3633",
            "fax_number": "931-363-3686"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "101 IVY LANE",
            "city": "PULASKI",
            "state": "TN",
            "postal_code": "38478",
            "telephone_number": "931-363-3633",
            "fax_number": "931-363-3686"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "IVY CREST, ACLF",
        "organizational_subpart": "NO",
        "enumeration_date": "2022-01-04",
        "last_updated": "2022-01-04",
        "certification_date": "2022-01-04",
        "status": "A",
        "authorized_official_last_name": "PRATT",
        "authorized_official_first_name": "CORA",
        "authorized_official_middle_name": "MARIE",
        "authorized_official_title_or_position": "ADMINISTRATOR",
        "authorized_official_telephone_number": "931-363-3633"
    },
    "taxonomies": [
        {
            "code": "310400000X",
            "taxonomy_group": "",
            "desc": "Assisted Living Facility",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• Assisted Living Facility in Pulaski, TN
• Providers in Pulaski, TN by specialty
• Assisted Living Facility in Tennessee

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 4, 2022; 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.