Organization
MAGNOLIA FIELDS AFCH LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
ALAYSHA CLARK (DIRECTOR/CEO)
(813) 507-5878
Entity
Organization
Contact information
Practice address
11309 CHILLY WATER CT, RIVERVIEW, FL 33569-2059
(813) 507-5878
Mailing address
11309 CHILLY WATER CT, RIVERVIEW, FL 33569-2059
Taxonomy
Speciality
Code
Description
License number
State
310400000X
Assisted Living Facility
Primary
—
—
Other
Enumeration date
06/08/2022
Last updated
06/08/2022
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