Organization
MAGNOLIA COTTAGE CARE, LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MS. SHERRY GRIFFIN S,W. (ADMINISTRATOR)
(252) 523-3297
Entity
Organization
Contact information
Practice address
5643 HWY 70, DOVER, NC 28526-8872
(252) 523-3297
(252) 520-0163
Mailing address
5643 HWY 70, DOVER, NC 28526-8872
(252) 523-3297
(252) 520-0163
Taxonomy
Speciality
Code
Description
License number
State
311ZA0620X
Adult Care Home Facility
Primary
FCL-052-004
NC
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
7804935
—
NC
Enumeration date
03/27/2007
Last updated
08/22/2020
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