Ivy Leaves Place, LLC

Primary specialty

Assisted Living FacilityTaxonomy code 310400000X

Legal business name

IVY LEAVES PLACE, LLC

Practice address

7199 Rendon Bloodworth Rd
Mansfield, TX 76063-4925

Phone

(817) 483-1294

NPI assigned

Dec 2, 2013

Organization subpart

No

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

Authorized official

Name

Mary NewmanNPI 1548690563

Title

Owner

Phone

(817) 808-7172

Specialties & licenses 1

Addresses

Other identifiers 1

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

• Mary Newman

  • Physical Disabilities Residential Treatment Facility
  • Mansfield, TX
  • NPI 1548690563
  NPD (past) Authorized official

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

{
    "created_epoch": "1385942400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1385942400000",
    "number": "1679904668",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "7199 RENDON BLOODWORTH RD",
            "city": "MANSFIELD",
            "state": "TX",
            "postal_code": "760634925",
            "telephone_number": "817-483-1294"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "7199 RENDON BLOODWORTH RD",
            "city": "MANSFIELD",
            "state": "TX",
            "postal_code": "760634925",
            "telephone_number": "817-483-1294"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "IVY LEAVES PLACE, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2013-12-02",
        "last_updated": "2013-12-02",
        "status": "A",
        "authorized_official_last_name": "NEWMAN",
        "authorized_official_first_name": "MARY",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "817-808-7172"
    },
    "taxonomies": [
        {
            "code": "310400000X",
            "taxonomy_group": "",
            "desc": "Assisted Living Facility",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "5646500178",
            "state": "TX"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Island Orthodontics
• Abdo Ismail, DDS, MS
• Iso Healthcare LLC
• Sierra Isom, NP
• Maurice Isuo, DC
• Linda Iyamah, PMHNP-BC
• Sylvester O Iyamah, PMHNP - BC
• Obehi Iyoha
• J-S Mansfield Operations, LP
• J. Kevin Turnipseed, Inc.

• Assisted Living Facility in Mansfield, TX
• Providers in Mansfield, TX by specialty
• Assisted Living Facility in Texas

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 2, 2013; 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.