# MAGNOLIA GRACE SENIOR CARE OF GEORGIA, LLC

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

## Provider details

- **NPI number:** 1518704220
- **Authorized official:** DINITRA N WRICE (OWNER/DIRECTOR)
- **Authorized official phone:** (904) 855-5114

## Contact information

- **Practice address:** 501 GLOUCESTER ST STE 115, BRUNSWICK, GA 31520-7030
- **Practice address phone:** (912) 266-8737
- **Practice address fax:** (912) 228-3400
- **Mailing address:** 1201 SHADOWLAWN DR STE 115, SAINT MARYS, GA 31558-4074
- **Mailing address phone:** (912) 266-8737
- **Mailing address fax:** (912) 228-3400

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 253Z00000X | In Home Supportive Care Agency | — | NULL | Yes |

## Other

- **Enumeration date:** 07/10/2024
- **Last updated:** 07/17/2024