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Organization

MAGNOLIA HOME CARE AGENCY LLC

Active
Organization subpart
No

Provider details

NPI number
Authorized official
KIMBERLY LASHAY WARD (CO-OWNER)
(901) 212-1469
Entity
Organization

Contact information

Practice address
7927 IRONWOOD DR, SOUTHAVEN, MS 38671-4406
(901) 212-1469
Mailing address
7927 IRONWOOD DR, SOUTHAVEN, MS 38671-4406
(901) 212-1469

Taxonomy

Speciality
Code
Description
License number
State
251E00000X
Home Health Agency
253Z00000X
In Home Supportive Care Agency
Primary
261QA0600X
Adult Day Care Clinic/Center
385H00000X
Respite Care

Other

Enumeration date
06/23/2023
Last updated
06/23/2023
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