Healthcare Provider Details

I. General information

NPI: 1215109566
Provider Name (Legal Business Name): MAGNIFIED HEALTH & REHAB OF ANDERSON, LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 03/27/2008
Last Update Date: 09/02/2014
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1115 ANDERSON ST
COLLEGE STATION TX
77840-4465
US

IV. Provider business mailing address

1115 ANDERSON ST
COLLEGE STATION TX
77840-4465
US

V. Phone/Fax

Practice location:
  • Phone: 979-693-1515
  • Fax: 979-696-0462
Mailing address:
  • Phone: 979-693-1515
  • Fax: 979-696-0462

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code314000000X
TaxonomySkilled Nursing Facility
License Number
License Number State

VIII. Authorized Official

Name: CHRISTOPHER J MURPHY
Title or Position: PRESIDENT
Credential:
Phone: 901-937-7994