Provider Demographics
NPI:1912557158
Name:IZARD HEALTH, LLC
Entity Type:Organization
Organization Name:IZARD HEALTH, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:MANAGER
Authorized Official - Prefix:
Authorized Official - First Name:CHRISTOPHER
Authorized Official - Middle Name:F
Authorized Official - Last Name:BROGDON
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:404-386-9607
Mailing Address - Street 1:1203 S BEND DR
Mailing Address - Street 2:
Mailing Address - City:HORSESHOE BEND
Mailing Address - State:AR
Mailing Address - Zip Code:72512-3727
Mailing Address - Country:US
Mailing Address - Phone:870-670-5134
Mailing Address - Fax:870-670-4251
Practice Address - Street 1:1203 S BEND DR
Practice Address - Street 2:
Practice Address - City:HORSESHOE BEND
Practice Address - State:AR
Practice Address - Zip Code:72512-3727
Practice Address - Country:US
Practice Address - Phone:870-670-5134
Practice Address - Fax:870-670-4251
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2019-09-19
Last Update Date:2019-09-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes314000000XNursing & Custodial Care FacilitiesSkilled Nursing Facility