Organization
MAGNOLIA HAVEN NURSING HOME LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MS. ANITA L EVANS (ADMINISTRATOR)
(334) 727-4960
Entity
Organization
Contact information
Practice address
603 WRIGHT ST, TUSKEGEE, AL 36083-1585
(334) 727-4960
(334) 727-2159
Mailing address
1 SOUTHERN WAY, MOBILE, AL 36619-1210
(251) 433-9801
(251) 433-9807
Taxonomy
Speciality
Code
Description
License number
State
314000000X
Skilled Nursing Facility
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
4751120S
—
AL
Enumeration date
06/17/2006
Last updated
11/14/2016
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