Ivy Reign Support Services

Primary specialty

Developmentally Disabled Services Day Training AgencyTaxonomy code 251C00000X

License

001007980 Issued in TX

Legal business name

IVY REIGN SUPPORT SERVICES

Practice address

4305 Gram LN
Waco, TX 76705-2661

Phone

(254) 799-3200

Fax

(254) 799-3204

NPI assigned

May 30, 2007

Organization subpart

No

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

Authorized official

Name

Mr. Terrance Toliver, MASTER OF SCIENCE

Title

Program Director

Phone

(254) 799-3200

Specialties & licenses 1

Addresses

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

{
    "created_epoch": "1180483200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1214438400000",
    "number": "1710188396",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4305 GRAM LN",
            "city": "WACO",
            "state": "TX",
            "postal_code": "767052661",
            "telephone_number": "254-799-3200",
            "fax_number": "254-799-3204"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4305 GRAM LN",
            "city": "WACO",
            "state": "TX",
            "postal_code": "767052661",
            "telephone_number": "254-799-3200",
            "fax_number": "254-799-3204"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "IVY REIGN SUPPORT SERVICES",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-05-30",
        "last_updated": "2008-06-26",
        "status": "A",
        "authorized_official_last_name": "TOLIVER",
        "authorized_official_first_name": "TERRANCE",
        "authorized_official_title_or_position": "PROGRAM DIRECTOR",
        "authorized_official_telephone_number": "254-799-3200",
        "authorized_official_name_prefix": "Mr.",
        "authorized_official_credential": "MASTER OF SCIENCE"
    },
    "taxonomies": [
        {
            "code": "251C00000X",
            "taxonomy_group": "",
            "desc": "Day Training, Developmentally Disabled Services",
            "state": "TX",
            "license": "001007980",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Destiny Leigh Irwin, FNP-C
• Patrice Islas
• Kevin Itty
• David W Ives, L.C.D.C.
• Nicole Nichelle Ivey, NP
• J. Phillip Myatt, M.D., PLLC Dba Waco Heart & Vascular
• Toby Caleb Jacinto III, PTA
• Jack Jones Hearing Centers, Inc.
• Aaron Ray Jackman, APRN PMHNP-BC
• April Irene Jackson, RDH

• Developmentally Disabled Services Day Training Agency in Waco, TX
• Providers in Waco, TX by specialty
• Developmentally Disabled Services Day Training Agency in Texas

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 26, 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.