Healthcare Provider Details

I. General information

NPI: 1457980583
Provider Name (Legal Business Name): IVORY BELLA NURSING & REHAB
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 04/01/2020
Last Update Date: 04/01/2020
Certification Date: 04/01/2020
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2428 WESTMONT DR
ROYAL PALM BEACH FL
33411-6138
US

IV. Provider business mailing address

1128 ROYAL PALM BEACH BLVD STE 243
ROYAL PALM BEACH FL
33411-1607
US

V. Phone/Fax

Practice location:
  • Phone: 561-301-3499
  • Fax:
Mailing address:
  • Phone: 561-301-3499
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code314000000X
TaxonomySkilled Nursing Facility
License Number
License Number State

VIII. Authorized Official

Name: GLOVETTA P WILLIAMS
Title or Position: P
Credential:
Phone: 561-301-3499