Organization
MGA, LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MR. PAUL M WALCZAK (CEO)
(561) 627-0664
Entity
Organization
Contact information
Practice address
811 KENNESAW AVE NW, MARIETTA, GA 30060-1002
(770) 422-2451
(770) 426-0462
Mailing address
2979 PGA BLVD, PALM BEACH GARDENS, FL 33410-2911
(561) 627-0664
(561) 627-2867
Taxonomy
Speciality
Code
Description
License number
State
314000000X
Skilled Nursing Facility
Primary
1-033-1720
GA
Other
Enumeration date
07/03/2007
Last updated
08/22/2020
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