Organization
MAGNA HOLDINGS, LLC
Active
Other names
Magnolia House Assisted Living
Organization subpart
No
Provider details
NPI number
Authorized official
GAVIN FOTHERGILL (OWNER)
(801) 230-4956
Entity
Organization
Contact information
Practice address
464 S MAIN ST, TOOELE, UT 84074-2748
(435) 833-0202
Mailing address
464 S MAIN ST, TOOELE, UT 84074-2748
(801) 230-4956
Taxonomy
Speciality
Code
Description
License number
State
385H00000X
Respite Care
Primary
—
UT
Other
Enumeration date
11/15/2013
Last updated
11/15/2013
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