Organization
SOUTHERN MAGNOLIA PERSONAL CARE HOME
Active
Organization
SOUTHERN MAGNOLIA PERSONAL CARE HOME
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MS. MAE LOIS DAY (OWNER)
(912) 537-2379
Entity
Organization
Contact information
Practice address
405 THOMPSON ST, VIDALIA, GA 30474-3120
(912) 537-2379
(912) 537-7040
Mailing address
405 THOMPSON ST, VIDALIA, GA 30474-3120
(912) 537-2379
(912) 537-7040
Taxonomy
Speciality
Code
Description
License number
State
305S00000X
Point of Service
Primary
442827106A
GA
Other
Enumeration date
01/27/2015
Last updated
01/27/2015
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