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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
251B00000X
Case Management Agency
Primary
251E00000X
Home Health Agency
251S00000X
Community/Behavioral Health Agency
252Y00000X
Early Intervention Provider Agency
261QD1600X
Developmental Disabilities Clinic/Center
385HR2055X
Child Mental Illness Respite Care
385HR2060X
Child Intellectual and/or Developmental Disabilities Respite Care
385HR2065X
Child Physical Disabilities Respite Care

Other

Enumeration date
08/18/2020
Last updated
08/18/2020
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