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Organization
IVY CREEK OF TALLAPOOSA, LLC
Active
Organization
IVY CREEK OF TALLAPOOSA, LLC
Active
Other names
LAKE MARTIN COMMUNITY HOSPITAL
Organization subpart
No
Provider details
NPI number
Authorized official
MICHAEL D BRUCE (CEO)
(334) 567-4311
Entity
Organization
Contact information
Practice address
201 MARIARDEN RD, DADEVILLE, AL 36853-6244
(256) 825-7821
(256) 825-5899
Mailing address
201 MARIARDEN RD, P.O BOX 629, DADEVILLE, AL 36853-6244
(256) 825-7821
(256) 825-5899
Taxonomy
Speciality
Code
Description
License number
State
282NR1301X
Rural Acute Care Hospital
Primary
11872
AL
Other
Enumeration date
07/17/2006
Last updated
04/05/2022
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