Organization
MAGNOLIS GARDENS, INC
Active
Other names
Magnolia Gardens Senior Care
Organization subpart
No
Provider details
NPI number
Authorized official
MS. KIM SIMPSON (CEO)
(252) 535-5006
Entity
Organization
Contact information
Practice address
829 ROANOKE AVE, ROANOKE RAPIDS, NC 27870-2717
(252) 308-1743
Mailing address
PO BOX 2042, ROANOKE RAPIDS, NC 27870-1242
(252) 535-5006
Taxonomy
Speciality
Code
Description
License number
State
310400000X
Assisted Living Facility
Primary
FCL-042-002
NC
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
7802782
—
NC
Enumeration date
02/28/2007
Last updated
08/22/2020
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