Organization
MAGNOLIA HOUSE
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MRS. TRACEY BRINN HARRISON (ADMINISTRATOR)
(321) 613-3029
Entity
Organization
Contact information
Practice address
103 YACHT HAVEN DR, COCOA BEACH, FL 32931-2627
(321) 613-3029
(321) 613-3029
Mailing address
103 YACHT HAVEN DR, COCOA BEACH, FL 32931-2627
(321) 613-3029
(321) 613-3029
Taxonomy
Speciality
Code
Description
License number
State
310400000X
Assisted Living Facility
Primary
AL11610
FL
Other
Enumeration date
03/26/2013
Last updated
03/26/2013
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