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Organization

MAGNOLIA FAMILY SERVICES LLC

Active
Organization subpart
No

Provider details

NPI number
Authorized official
MR. DONALD B OLIVIER II MBA (CEO)
(985) 449-4055
Entity
Organization

Contact information

Practice address
1418 TIGER DR, THIBODAUX, LA 70301-4337
(985) 449-4055
(985) 449-4178
Mailing address
1418 TIGER DR, THIBODAUX, LA 70301-4337
(985) 449-4055
(985) 449-4178

Taxonomy

Speciality
Code
Description
License number
State
251S00000X
Community/Behavioral Health Agency
Primary
1176621
LA
261QM0801X
Mental Health Clinic/Center (Including Community Mental Health Center)

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
1176621
LA
01
600720425
MAGELLAN HEALTH SERVICES
LA
Enumeration date
03/22/2007
Last updated
06/08/2023
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