Organization
MAGNOLIA WOODS SENIOR VILLAGE, INC
Active
Parent organization
MAGNOLIA WOODS SENIOR VILLAGE, INC.
Other names
The Gardens of Pamlico
Organization subpart
Yes
Provider details
NPI number
Legal business name
MAGNOLIA WOODS SENIOR VILLAGE, INC.
Authorized official
MR. EDWARD LEE BARHAM JR. (ADMINISTRATOR / OWNER)
(252) 745-8208
Entity
Organization
Contact information
Practice address
22 MAGNOLIA WAY, GRANTSBORO, NC 28529-0276
(252) 745-8208
(252) 745-5424
Mailing address
P.O. BOX 276, GRANTSBORO, NC 28529-0276
(252) 745-8208
(252) 745-5424
Taxonomy
Speciality
Code
Description
License number
State
310400000X
Assisted Living Facility
Primary
HAL 069001
NC
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
7806722
—
NC
Enumeration date
03/27/2007
Last updated
12/12/2012
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