Organization
MAGNOLIA HOME CARE LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MRS. CHARITY D FORD MSW (PRESIDENT)
(757) 831-2968
Entity
Organization
Contact information
Practice address
921 LEE SHORE COURT, CHESAPEAKE, VA 23320-0734
(866) 866-2465
(866) 866-2465
Mailing address
921 LEE SHORE CT, CHESAPEAKE, VA 23320-0734
(866) 866-2465
(866) 866-2465
Taxonomy
Speciality
Code
Description
License number
State
253Z00000X
In Home Supportive Care Agency
Primary
0001062
CT
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
0001062
HOME CARE LICENSE NUMBER
CT
Enumeration date
11/19/2015
Last updated
10/06/2016
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