Organization
MAGNOLA MANOR AT DAYTONA BEACH, LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
SAVITRI JOHNSON (ADMINISTRATIVE ASSISTANT)
(863) 226-0358
Entity
Organization
Contact information
Practice address
252 FOREST LAKE BLVD, DAYTONA BEACH, FL 32119-8106
(863) 226-0358
Mailing address
59 LAKE MORTON DR, LAKELAND, FL 33801-5344
Taxonomy
Speciality
Code
Description
License number
State
310400000X
Assisted Living Facility
Primary
AL8869
FL
Other
Enumeration date
08/29/2016
Last updated
02/16/2022
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