Organization
MAGNOLIA GARDENS ASSISTED LIVING
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MRS. DEBORAH DARLENE STEVERSON LPN (OWNER/ADMINISTRATOR)
(601) 649-6660
Entity
Organization
Contact information
Practice address
945 WEST DR, LAUREL, MS 39440-4703
(601) 649-6660
(601) 428-4685
Mailing address
945 WEST DR, LAUREL, MS 39440-4703
(601) 649-6660
(601) 428-4685
Taxonomy
Speciality
Code
Description
License number
State
3104A0630X
Assisted Living Facility (Behavioral Disturbances)
Primary
898
MS
347C00000X
Private Vehicle
898
MS
385H00000X
Respite Care
898
MS
Other
Enumeration date
08/10/2007
Last updated
08/10/2007
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