OrganizationActive
Ivy Lane Residence LLC
NPI 1679341770 · Adult Care Home Facility · Wyoming, MI
Ivy Lane Residence LLC is a Adult Care Home Facility organization in Wyoming, MI (NPI 1679341770).
Provider details
- NPI number
- 1679341770
- Entity type
- Organization
- Primary specialty
- Adult Care Home FacilityNursing & Custodial Care Facilities
- Organization subpart
- No
- Authorized official
- Najib Moalin, Director(612) 232-5643
Specialties & taxonomies
Nursing & Custodial Care Facilities
Profile Score
Established profile(57/100 index)
A profile completeness & documented-activity index — NOT a quality, outcomes, or patient-satisfaction rating.
- Registry tenure38% of score
2 yrs in NPPES registry
- Profile completeness38% of score
100% of core fields populated
- Practice footprint23% of score
1 documented practice location
Signals a provider has no public data for (e.g. Medicare claims) are left out of the score entirely — never counted as zero — so providers without that data are not penalized. See the full formula and weights in our methodology.
Practice location
4897 Grenadier Dr Sw
Wyoming, MI 49509-5021
Phone: (612) 232-5643
Street-level locationGet directions
Mailing address
4897 Grenadier Dr Sw
Wyoming, MI 49509-5021
Registry dates
- Enumerated
- 2023-12-18
- Last updated
- 2023-12-18
- Certified
- 2023-12-18
Frequently asked questions
- What is Ivy Lane Residence LLC's NPI number?
- Ivy Lane Residence LLC's National Provider Identifier (NPI) is 1679341770, a unique 10-digit ID issued by CMS for use in standard healthcare transactions.
- What type of organization is Ivy Lane Residence LLC?
- Ivy Lane Residence LLC is classified in the NPPES registry as Adult Care Home Facility (Nursing & Custodial Care Facilities).
- Where is Ivy Lane Residence LLC located?
- Ivy Lane Residence LLC's practice location on file with NPPES is 4897 Grenadier Dr Sw, Wyoming, MI 49509-5021.
- What is Ivy Lane Residence LLC's phone number?
- The practice phone number listed in the NPPES registry for Ivy Lane Residence LLC is (612) 232-5643.
- Who is the authorized official for Ivy Lane Residence LLC?
- The authorized official listed on Ivy Lane Residence LLC's NPPES record is Najib Moalin, Director. The authorized official registers and maintains the organization's NPI and is not necessarily its owner.
- Is Ivy Lane Residence LLC's NPI active?
- Yes — Ivy Lane Residence LLC's NPI (1679341770) is active in the NPPES registry as of the last update on 2023-12-18.
Source: CMS NPPES Data Dissemination (June 2026). NPI Central is not affiliated with CMS. Data is provided as-is from the public registry.