| Ivey House Llc | |
|
1417 Madison St High Point NC 27262-2655 | |
| (910) 434-4763 | |
| Not Available |
| Full Name | Ivey House Llc |
|---|---|
| Speciality | Community Based Residential Treatment Facility, Mental Illness |
| Location | 1417 Madison St, High Point, North Carolina |
| Authorized Official Name and Position | Chanel Quick (CEO) |
| Authorized Official Contact | 9104344763 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Ivey House Llc 4207 Triston Dr Greensboro NC 27407-7547 Ph: (910) 434-4763 | Ivey House Llc 1417 Madison St High Point NC 27262-2655 Ph: (910) 434-4763 |
| NPI Number | 1083597074 |
|---|---|
| Provider Enumeration Date | 07/28/2025 |
| Last Update Date | 07/28/2025 |
| Certification Date | 07/28/2025 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1083597074 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 251S00000X | Community/behavioral Health | (* (Not Available)) | Secondary |
| 320800000X | Community Based Residential Treatment Facility, Mental Illness | (* (Not Available)) | Primary |
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