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General NPI Number Information
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NPI Number | 1013628593
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Entity Type | Organization
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Legal Business Name | MAGNOLIA ADULT DAY CARE CENTER
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Dates
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Enumeration Date | 12/06/2022
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Last Update Date | 11/20/2025
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Provider Practice Location Address
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Address Line | 4745 NW 7TH CT
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City | BOYNTON BEACH
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State | FL
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Zip | 33426-9340
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Country | US
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Telephone | 720-934-1122
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Fax | 303-484-4024
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Provider Business Mailing Address
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Address Line | 4745 NW 7TH CT
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City | BOYNTON BEACH
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State | FL
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Zip | 33426-9340
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Country | US
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Telephone | 720-934-1122
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Fax | 303-484-4024
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Authorized Official
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Title or Position | ADMINISTRATOR
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Name | EDWARD RUVINS
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Credential |
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Telephone | 720-934-1122
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 261QA0600X
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Taxonomy Name | Adult Day Care Clinic/Center
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License Number |
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License Number State |
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