Organization
MAGNOLIA CARE HOME 1 LLC
Active
Other names
Magnolia Care Home 1
Organization subpart
No
Provider details
NPI number
Authorized official
MARIAM GBATY SOUMAHORO (ADMINISTRATOR)
(510) 409-7096
Entity
Organization
Contact information
Practice address
4727 SONGWOOD CT, STOCKTON, CA 95206-6228
(510) 409-7096
Mailing address
4727 SONGWOOD CT, STOCKTON, CA 95206-6228
(510) 409-7096
Taxonomy
Speciality
Code
Description
License number
State
310400000X
Assisted Living Facility
Primary
—
—
Other
Enumeration date
12/26/2022
Last updated
12/26/2022
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