Organization
MAGNOLIA SQUARE NURSING AND REHABILITATION CENTER LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MR. MICHAEL S. MORTON (PRESIDENT)
(479) 783-4672
Entity
Organization
Contact information
Practice address
1502 W EDGEWOOD ST, SPRINGFIELD, MO 65807-3567
(417) 877-7545
Mailing address
415 ROGERS AVE, FORT SMITH, AR 72901-1903
(479) 783-4672
(479) 783-2217
Taxonomy
Speciality
Code
Description
License number
State
314000000X
Skilled Nursing Facility
Primary
031934
MO
Other
Enumeration date
05/23/2006
Last updated
10/16/2007
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