Ivy Ridge Care Inc

Primary specialty

Assisted Living FacilityTaxonomy code 310400000X

Legal business name

IVY RIDGE CARE INC

Doing business as

Ivy Ridge Assisited Living

Practice address

2030 23Rd St
Sacramento, CA 95818-1718

Phone

(916) 813-8018

NPI assigned

Aug 15, 2023

Organization subpart

No

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

Authorized official

Name

Pak Keung Wu

Title

Ceo

Phone

(916) 813-8018

Specialties & licenses 1

Addresses

Other names 1

• Ivy Ridge Assisited Living Doing business as

Locations

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

{
    "created_epoch": "1692057600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1692057600000",
    "number": "1568245447",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5050 LAGUNA BLVD",
            "address_2": "STE 112 #798",
            "city": "ELK GROVE",
            "state": "CA",
            "postal_code": "957584151",
            "telephone_number": "916-813-8018"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2030 23RD ST",
            "city": "SACRAMENTO",
            "state": "CA",
            "postal_code": "958181718",
            "telephone_number": "916-813-8018"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "IVY RIDGE CARE INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2023-08-15",
        "last_updated": "2023-08-15",
        "certification_date": "2023-08-15",
        "status": "A",
        "authorized_official_last_name": "WU",
        "authorized_official_first_name": "PAK",
        "authorized_official_middle_name": "KEUNG",
        "authorized_official_title_or_position": "CEO",
        "authorized_official_telephone_number": "916-813-8018"
    },
    "taxonomies": [
        {
            "code": "310400000X",
            "taxonomy_group": "",
            "desc": "Assisted Living Facility",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Ivy Ridge Assisited Living",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

• Howard Rollin Ives
• Alexandria Ivey
• Robert J. Ivory
• Ivy Griffin
• Ivy Griffin Private Practice
• Vichelle Jhane Ivy
• Ivyarupa Sunkara DDS Inc
• Ivyridge Assisted Living
• Allison Emiko Iwamoto, FNP-C, RN
• Satori Iwamoto

• Assisted Living Facility in Sacramento, CA
• Providers in Sacramento, CA by specialty
• Assisted Living Facility in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 15, 2023; 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.