Provider Demographics
NPI:1205497765
Name:IVORY HOME HEALTH CARE, INC
Entity type:Organization
Organization Name:IVORY HOME HEALTH CARE, INC
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:CEO
Authorized Official - Prefix:
Authorized Official - First Name:ADWOA SERWA
Authorized Official - Middle Name:
Authorized Official - Last Name:OSEI NYARKO
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:562-349-0860
Mailing Address - Street 1:3605 LONG BEACH BLVD STE 331
Mailing Address - Street 2:
Mailing Address - City:LONG BEACH
Mailing Address - State:CA
Mailing Address - Zip Code:90807-4025
Mailing Address - Country:US
Mailing Address - Phone:562-349-0860
Mailing Address - Fax:562-285-7216
Practice Address - Street 1:3605 LONG BEACH BLVD STE 331
Practice Address - Street 2:
Practice Address - City:LONG BEACH
Practice Address - State:CA
Practice Address - Zip Code:90807-4025
Practice Address - Country:US
Practice Address - Phone:562-349-0860
Practice Address - Fax:562-285-7216
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2019-06-25
Last Update Date:2024-02-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251E00000XAgenciesHome Health
No251B00000XAgenciesCase Management
No251F00000XAgenciesHome Infusion
No251J00000XAgenciesNursing Care
No251K00000XAgenciesPublic Health or Welfare
No251S00000XAgenciesCommunity/Behavioral Health
No251T00000XAgenciesProgram of All-Inclusive Care for the Elderly (PACE) Provider Organization
No251V00000XAgenciesVoluntary or Charitable
No252Y00000XAgenciesEarly Intervention Provider Agency
No261Q00000XAmbulatory Health Care FacilitiesClinic/Center
No332B00000XSuppliersDurable Medical Equipment & Medical Supplies