Organization
PATMAX LLC
Active
Other names
Magnolia Home Care
Organization subpart
No
Provider details
NPI number
Authorized official
LEA THACH REGISTERED NURSE (OWNER)
(803) 547-1866
Entity
Organization
Contact information
Practice address
1251 ARROW PINE DR STE E, CHARLOTTE, NC 28273-5591
(704) 258-1784
Mailing address
2631 FARMSTEAD LN, FORT MILL, SC 29708-7939
(704) 258-1784
Taxonomy
Speciality
Code
Description
License number
State
251T00000X
PACE Provider Organization
—
—
253Z00000X
In Home Supportive Care Agency
Primary
—
—
385H00000X
Respite Care
—
—
Other
Enumeration date
03/15/2023
Last updated
03/20/2023
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