OrganizationActive
Ivy Creek of Elmore, LLC
NPI 1578060349 · Rural Health Clinic/Center · Deatsville, AL
Provider details
- NPI number
- 1578060349
- Entity type
- Organization
- Primary specialty
- Rural Health Clinic/CenterAmbulatory Health Care Facilities
- Organization subpart
- No
- Authorized official
- Jade Lane, Credentialing Manager(334) 567-4311
Specialties & taxonomies
Ambulatory Health Care Facilities
Practice location
4412 Hogan Rd
Deatsville, AL 36022-3400
Phone: (334) 514-4851
Fax: (334) 543-4854
Approximate (ZIP-level) locationGet directions
Mailing address
Po Box 130
Wetumpka, AL 36092-0003
Other names (DBA / former)
- Doing business as
- Ivy Creek Family Care of Holtville
Registry dates
- Enumerated
- 2018-04-09
- Last updated
- 2025-03-20
- Certified
- 2025-03-20
Source: CMS NPPES Data Dissemination (June 2026). NPI Central is not affiliated with CMS. Data is provided as-is from the public registry.