Healthcare Provider Details

I. General information

NPI: 1194633131
Provider Name (Legal Business Name): IVY JJ OPCO LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 08/31/2026
Last Update Date: 08/31/2026
Certification Date: 08/31/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2004 OLD ARCH RD
NORRISTOWN PA
19401-2008
US

IV. Provider business mailing address

2004 OLD ARCH RD
NORRISTOWN PA
19401-2008
US

V. Phone/Fax

Practice location:
  • Phone: 610-277-0380
  • Fax:
Mailing address:
  • Phone:
  • 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: AVROHOM BROWN
Title or Position: MANAGER
Credential:
Phone: 845-642-9186