# MAGNOLIA OF MADISON, INC.

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- **Entity:** Organization
- **Status:** Active
- **Organization subpart:** No

## Provider details

- **NPI number:** 1376547349
- **Authorized official:** CARL LEN MACHEN R.N. (ADMINISTRATOR, DON)
- **Authorized official phone:** (318) 574-6400

## Contact information

- **Practice address:** 708 LASALLE ST., TALLULAH, LA 71282
- **Practice address phone:** (318) 574-6400
- **Practice address fax:** (318) 574-6401
- **Mailing address:** 708 LASALLE ST., TALLULAH, LA 71282
- **Mailing address phone:** (318) 574-6400
- **Mailing address fax:** (318) 574-6401

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 251E00000X | Home Health Agency | 860 | LA | Yes |

## Other

- **Enumeration date:** 06/08/2005
- **Last updated:** 08/22/2020