Organization
MAGNOLIA'S HEART INCORPORATED LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
LISA MOFFETT LCSW (CEO)
(702) 201-1657
Entity
Organization
Contact information
Practice address
4550 W OAKEY BLVD STE 111M, LAS VEGAS, NV 89102-1581
(702) 201-1657
(702) 921-3333
Mailing address
PO BOX 46212, LAS VEGAS, NV 89114-6212
(702) 201-1657
(702) 921-3333
Taxonomy
Speciality
Code
Description
License number
State
1041C0700X
Clinical Social Worker
Primary
—
—
Other
Enumeration date
05/01/2013
Last updated
04/19/2020
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