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Organization

THE IVY CENTER, LLC

Active
Organization subpart
No

Provider details

NPI number
Authorized official
JUANTIA MARSHALL (OWNER)
(405) 827-4666
Entity
Organization

Contact information

Practice address
15980 TRAILHEAD RD, MCLOUD, OK 74851-5015
(405) 827-4666
(405) 383-4756
Mailing address
15980 TRAILHEAD RD, MCLOUD, OK 74851-5015
(405) 827-4666
(405) 383-4756

Taxonomy

Speciality
Code
Description
License number
State
101YM0800X
Mental Health Counselor
Primary
251S00000X
Community/Behavioral Health Agency
Primary

Other

Enumeration date
07/03/2024
Last updated
02/18/2026
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