Organization
FIVE MAGNOLIAS ASSISTED LIVING
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MS. SHARON J JOHNSON MS (ADMINISTRATOR)
(813) 486-0702
Entity
Organization
Contact information
Practice address
6116 AUDUBON MANOR BLVD, LITHIA, FL 33547-5031
(813) 486-0702
(813) 315-8965
Mailing address
6116 AUDUBON MANOR BLVD, LITHIA, FL 33547-5031
(813) 486-0702
(813) 315-8965
Taxonomy
Speciality
Code
Description
License number
State
3104A0625X
Assisted Living Facility (Mental Illness)
Primary
AL12457
FL
Other
Enumeration date
04/25/2014
Last updated
04/25/2014
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