Ivy Gate LLC

Primary specialty

Assisted Living Facility (Behavioral Disturbances)Taxonomy code 3104A0630X

Legal business name

IVY GATE LLC

Doing business as

Ivy Gate Assisted Living Facility

Practice address

5017 Kings Dr
Adamsville, AL 35005-1814

Phone

(205) 266-1956

NPI assigned

Dec 17, 2020

Organization subpart

No

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

Authorized official

Name

Ms. Alexandria Nicole Hilliard, LPN

Title

Owner

Phone

(205) 266-1956

Specialties & licenses 1

Addresses

Other names 1

• Ivy Gate Assisted Living Facility Doing business as

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

{
    "created_epoch": "1608163200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1608163200000",
    "number": "1811583370",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5017 KINGS DR",
            "city": "ADAMSVILLE",
            "state": "AL",
            "postal_code": "350051814",
            "telephone_number": "205-266-1956"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5017 KINGS DR",
            "city": "ADAMSVILLE",
            "state": "AL",
            "postal_code": "350051814",
            "telephone_number": "205-266-1956"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "IVY GATE LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2020-12-17",
        "last_updated": "2020-12-17",
        "certification_date": "2020-12-17",
        "status": "A",
        "authorized_official_last_name": "HILLIARD",
        "authorized_official_first_name": "ALEXANDRIA",
        "authorized_official_middle_name": "NICOLE",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "205-266-1956",
        "authorized_official_name_prefix": "Ms.",
        "authorized_official_credential": "LPN"
    },
    "taxonomies": [
        {
            "code": "3104A0630X",
            "taxonomy_group": "",
            "desc": "Assisted Living Facility, Assisted Living, Behavioral Disturbances",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Ivy Gate Assisted Living Facility",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

• Boyd Kenway Cougle Jr., PHARMD
• Thomas Lynn Dunn, DMD LLC
• Shundra Ptomey Gichuru
• Deanna Hatcher, LPC
• Salonya Howard, LPC
• Mark J. Richman, MD PC
• New Path Health Career Center, LLC
• Corey Nichols, PHARM.D.
• Matthew B Reamsma, PHARMD
• Mark Joseph Richman, MD

• Assisted Living Facility (Behavioral Disturbances) in Adamsville, AL
• Providers in Adamsville, AL by specialty
• Assisted Living Facility (Behavioral Disturbances) in Alabama

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 17, 2020; 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.