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General NPI Number Information
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NPI Number | 1093677254
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Entity Type | Organization
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Legal Business Name | IVORY GLOBAL CARE LLC
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Dates
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Enumeration Date | 11/26/2025
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Last Update Date | 11/26/2025
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Provider Practice Location Address
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Address Line | 9595 SIX PINES DR BLDG 8 LEVEL 2, SUITE 8210
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City | THE WOODLANDS
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State | TX
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Zip | 77380-1531
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Country | US
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Telephone | 281-723-1795
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Fax |
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Provider Business Mailing Address
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Address Line | 9595 SIX PINES DR BLDG 8
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City | THE WOODLANDS
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State | TX
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Zip | 77380-1531
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Country | US
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Telephone | 281-723-1795
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Fax |
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Authorized Official
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Title or Position | CEO/OWNER
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Name | ANNICK JACKSON
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Credential |
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Telephone | 281-723-1795
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 101YM0800X
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Taxonomy Name | Mental Health Counselor
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License Number |
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License Number State |
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Taxonomy #2
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Taxonomy Code | 363LP0808X
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Taxonomy Name | Psychiatric/Mental Health Nurse Practitioner
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License Number |
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License Number State |
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