Organization
MAGNOLIA CARE AFC HOME LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
CARRIE LYNN DEXTROM (OWNER)
(231) 878-8352
Entity
Organization
Contact information
Practice address
9200 W WALKER RD, MANTON, MI 49663-9315
(231) 839-4585
Mailing address
9200 W WALKER RD, MANTON, MI 49663-9315
(231) 839-4585
Taxonomy
Speciality
Code
Description
License number
State
253J00000X
Foster Care Agency
Primary
—
—
Other
Enumeration date
10/30/2018
Last updated
10/30/2018
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