Ivy Harris

Individual provider Intellectual and/or Developmental Disabilities Residential Treatment Facility · NPI 1073926812

Ivy Harris is an Intellectual and/or Developmental Disabilities Residential Treatment Facility in Grovetown, Georgia. Practices as a sole proprietor. Registered with an NPI since 2014.

In the registry since: 2014

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Practice location Address checks out

4613 Marthas Way
Grovetown, GA 30813-2205
Phone: (732) 962-5450

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Specialties & licences

Intellectual and/or Developmental Disabilities Residential Treatment Facility (primary)	Taxonomy 320600000X

Record details

NPI number	1073926812
Entity type	Individual (Type 1)
Gender	Female
Sole proprietor	Yes
NPI enumerated	June 10, 2014
Last updated in NPPES	June 10, 2014
Mailing address	4613 Martha'S Way, Grovetown, GA 30813