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Organization
IVYHEALTH NETWORK LLC DBA IVY HEALTH NETWORK
Active
Organization
IVYHEALTH NETWORK LLC DBA IVY HEALTH NETWORK
Active
Organization subpart
No
Provider details
NPI number
Authorized official
JANEAU DEESE (OWNER)
(248) 789-8504
Entity
Organization
Contact information
Practice address
32799 WOODWARD AVE STE 1, ROYAL OAK, MI 48073-0954
(248) 789-8504
Mailing address
32799 WOODWARD AVE STE 1, ROYAL OAK, MI 48073-0954
(248) 789-8504
Taxonomy
Speciality
Code
Description
License number
State
171M00000X
Case Manager/Care Coordinator
—
NULL
171M00000X
Case Manager/Care Coordinator
—
—
251B00000X
Case Management Agency
Primary
—
NULL
251E00000X
Home Health Agency
—
NULL
251S00000X
Community/Behavioral Health Agency
—
NULL
252Y00000X
Early Intervention Provider Agency
—
NULL
261QD1600X
Developmental Disabilities Clinic/Center
—
NULL
385HR2055X
Child Mental Illness Respite Care
—
NULL
385HR2060X
Child Intellectual and/or Developmental Disabilities Respite Care
—
NULL
385HR2065X
Child Physical Disabilities Respite Care
—
NULL
Other
Enumeration date
08/18/2020
Last updated
08/18/2020
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