# MAGNOLIA COTTAGE CARE, LLC

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

## Provider details

- **NPI number:** 1669590709
- **Authorized official:** MS. SHERRY GRIFFIN S,W. (ADMINISTRATOR)
- **Authorized official phone:** (252) 523-3297

## Contact information

- **Practice address:** 5643 HWY 70, DOVER, NC 28526-8872
- **Practice address phone:** (252) 523-3297
- **Practice address fax:** (252) 520-0163
- **Mailing address:** 5643 HWY 70, DOVER, NC 28526-8872
- **Mailing address phone:** (252) 523-3297
- **Mailing address fax:** (252) 520-0163

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 311ZA0620X | Adult Care Home Facility | FCL-052-004 | NC | Yes |

## Other

- **Enumeration date:** 03/27/2007
- **Last updated:** 08/22/2020

## Other identifiers

| Code | Description | Identifier | Issuer | State |
| --- | --- | --- | --- | --- |
| 05 | — | 7804935 | — | NC |