Organization
IVY REIGN SUPPORT SERVICES
Active
Organization
IVY REIGN SUPPORT SERVICES
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MR. TERRANCE TOLIVER MASTER OF SCIENCE (PROGRAM DIRECTOR)
(254) 799-3200
Entity
Organization
Contact information
Practice address
4305 GRAM LN, WACO, TX 76705-2661
(254) 799-3200
(254) 799-3204
Mailing address
4305 GRAM LN, WACO, TX 76705-2661
(254) 799-3200
(254) 799-3204
Taxonomy
Speciality
Code
Description
License number
State
251C00000X
Developmentally Disabled Services Day Training Agency
Primary
001007980
TX
Other
Enumeration date
05/30/2007
Last updated
06/26/2008
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