Organization
MAGNIFICENT HOMECARE LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MS. SHAQUAZLYN GRANADA GEORGE (ADMINISTRATOR)
(478) 318-8799
Entity
Organization
Contact information
Practice address
182 RILEY AVE STE F2, MACON, GA 31204-0778
(478) 318-8799
Mailing address
PO BOX 3831, MACON, GA 31205-3831
(478) 318-8799
Taxonomy
Speciality
Code
Description
License number
State
251E00000X
Home Health Agency
Primary
—
—
Other
Enumeration date
12/05/2019
Last updated
12/05/2019
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