Healthcare Provider Details

I. General information

NPI: 1922932888
Provider Name (Legal Business Name): IVY HEALTHCARE, INC.
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 06/08/2026
Last Update Date: 06/08/2026
Certification Date: 06/08/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

78000 FRED WARING DR STE 102
PALM DESERT CA
92211-9266
US

IV. Provider business mailing address

78000 FRED WARING DR STE 102
PALM DESERT CA
92211-9266
US

V. Phone/Fax

Practice location:
  • Phone: 800-654-2212
  • Fax: 800-992-9356
Mailing address:
  • Phone: 800-654-2212
  • Fax: 800-992-9356

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code251E00000X
TaxonomyHome Health Agency
License Number
License Number State

VIII. Authorized Official

Name: MS. DARCY T. AVILES
Title or Position: ADMINISTRATOR
Credential: LPCC
Phone: 760-639-7100