IL
IVY LANE RESIDENCE LLC
Custodial Care Facility
OIG CLEARNPI VERIFIED
Location
WYOMING, MI
Licensed since
2023
Rate
—
Federal identifiers
NPI registry number1679341770
Agency details
Medicare activity
StatusNo Medicare utilization on file — neutral.
Authorized official
NameNAJIB MOALIN
TitleDIRECTOR
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