Organization
MAGNOLIA HOME CARE/PDN
Active
Organization subpart
No
Provider details
NPI number
Authorized official
LANORA FAY MILLS RN (OWNER/PROGRAM DIRECTOR)
(225) 268-0398
Entity
Organization
Contact information
Practice address
11832 NEWCASTLE AVE, SUITE 1, BATON ROUGE, LA 70816-8997
(225) 268-0398
Mailing address
12073 W ENGLAND AVE, BATON ROUGE, LA 70814-7742
(225) 268-0398
Taxonomy
Speciality
Code
Description
License number
State
253Z00000X
In Home Supportive Care Agency
Primary
PCA15162
LA
Other
Enumeration date
05/07/2009
Last updated
05/07/2009
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