MEDICARE: MAGNOLIA'S FAMILY HOME CARE

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy
1	372600000X	Adult Companion
2	376J00000X	Homemaker
3	385HR2060X	Child Intellectual and/or Developmental Disabilities Respite Care
4	253Z00000X	In Home Supportive Care Agency
5	320900000X	Intellectual and/or Developmental Disabilities Community Based Residential Treatment Facility

General Provider Information

NPI Number	:	1568925956
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	MAGNOLIA'S FAMILY HOME CARE

Provider Business Mailing Address
First Line	:	3001 W SILVER SPRINGS BLVD STE 7
Second Line	:
City	:	OCALA
State	:	FL
Zip	:	34475-5647
Country	:	US
Telephone Number	:	352-454-4324
Fax Number	:

Provider Business Practice Location Address
First Line	:	3001 W SILVER SPRINGS BLVD STE 7
Second Line	:
City	:	OCALA
State	:	FL
Zip	:	34475-5647
Country	:	US
Telephone Number	:	352-454-4324
Fax Number	:

Authorized Official
Title or Position	:	OWNER
Name	:	MRS. SERENA TIRRELL STEWART
Credential	:
Telephone Number	:	352-454-4324

Provider Enumeration Date	:	04/11/2019
Last Update Date	:	04/11/2019

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