Organization
MAGNOLIA MANOR SENIOR DAY PROGRAM, LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MRS. SARA A. O'NEAL CNA (OWNER/ADMINISTRATOR)
(850) 362-6556
Entity
Organization
Contact information
Practice address
141 BARKS DR, FORT WALTON BEACH, FL 32547-6774
(850) 225-2985
Mailing address
141 BARKS DR, FORT WALTON BEACH, FL 32547-6774
(850) 225-2985
Taxonomy
Speciality
Code
Description
License number
State
261QA0600X
Adult Day Care Clinic/Center
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
000706400
—
FL
Enumeration date
10/16/2013
Last updated
10/16/2013
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