Organization
MAGNOLIA SENIOR CARE LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MRS. TINA ELLIS (COMPTROLLER)
(601) 366-1712
Entity
Organization
Contact information
Practice address
3701 PETER QUINN DR, JACKSON, MS 39213-3309
(601) 366-1712
(601) 366-1715
Mailing address
3701 PETER QUINN DR, JACKSON, MS 39213-3309
(601) 366-1712
(601) 366-1715
Taxonomy
Speciality
Code
Description
License number
State
314000000X
Skilled Nursing Facility
Primary
404
MS
Other
Enumeration date
08/10/2007
Last updated
08/10/2007
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