Organization
MAGNOLIA GARDENS ASSISTED LIVING, INC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MRS. DEBORAH DARLENE STEVERSON LPN (OWNER/DIRECTOR)
(601) 477-9041
Entity
Organization
Contact information
Practice address
945 WEST DR, LAUREL, MS 39440-4703
(601) 477-9041
Mailing address
945 WEST DR, LAUREL, MS 39440-4703
(601) 477-9041
Taxonomy
Speciality
Code
Description
License number
State
310400000X
Assisted Living Facility
Primary
898
MS
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
00585888
—
MS
Enumeration date
01/09/2012
Last updated
01/09/2012
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