Ivy Lane Residence LLC
Ivy Lane Residence LLC is an Adult Care Home Facility in Wyoming, Michigan. Registered with an NPI since 2023.
- In the registry since
- 2023
What do these letters mean?
- LLC — Limited liability company
- A form of business registration, not a clinical qualification.
Practice location Address checks out
4897 Grenadier Dr SWWyoming, MI 49509-5021
Phone: (612) 232-5643
Show map & directions
Directions in Google Maps · Apple Maps · OpenStreetMap
Pin is approximate — placed at the ZIP-code centre, not the exact door.
Specialties & licences
| Adult Care Home Facility (primary) | Taxonomy 311ZA0620X |
|---|
Record details
| NPI number | 1679341770 |
|---|---|
| Entity type | Organization (Type 2) |
| Organization subpart | No |
| Authorized official | Najib Moalin — Director · (612) 232-5643 |
| NPI enumerated | December 18, 2023 |
| Last updated in NPPES | December 18, 2023 |
| Certification date | December 18, 2023 |
| Mailing address | 4897 Grenadier Dr Sw, Wyoming, MI 49509-5021 |
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