Organization
MAGNOLIA MANOR MANAGEMENT INC
Active
Other names
Magnolia Manor
Organization subpart
No
Provider details
NPI number
Authorized official
MR. WAYNE POWELL (DIRECTOR)
(469) 293-0002
Entity
Organization
Contact information
Practice address
510 E BONHAM ST, JEFFERSON, TX 75657-1506
(903) 665-3903
(903) 665-2410
Mailing address
510 E BONHAM ST, JEFFERSON, TX 75657-1506
(903) 665-3903
(903) 665-2410
Taxonomy
Speciality
Code
Description
License number
State
314000000X
Skilled Nursing Facility
Primary
—
—
Other
Enumeration date
07/24/2007
Last updated
07/24/2007
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