Provider Demographics
NPI:1528402500
Name:IVORY THERAPY SERVICES
Entity Type:Organization
Organization Name:IVORY THERAPY SERVICES
Other - Org Name:IVORY HEALTH CARE SERVICES
Other - Org Type:Doing Business As
Authorized Official - Title/Position:DIRECTOR
Authorized Official - Prefix:
Authorized Official - First Name:MOUSSA
Authorized Official - Middle Name:
Authorized Official - Last Name:DIABY
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:202-230-9361
Mailing Address - Street 1:8955 EDMONSTON RD
Mailing Address - Street 2:SUITE E
Mailing Address - City:GREENBELT
Mailing Address - State:MD
Mailing Address - Zip Code:20770-1006
Mailing Address - Country:US
Mailing Address - Phone:202-230-9361
Mailing Address - Fax:301-313-9009
Practice Address - Street 1:8955 EDMONSTON RD
Practice Address - Street 2:SUITE E
Practice Address - City:GREENBELT
Practice Address - State:MD
Practice Address - Zip Code:20770-1006
Practice Address - Country:US
Practice Address - Phone:202-230-9361
Practice Address - Fax:301-313-9009
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2013-04-22
Last Update Date:2013-04-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251E00000XAgenciesHome Health