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General NPI Number Information
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NPI Number | 1114813532
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Entity Type | Organization
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Legal Business Name | MAGNOLIA CARE LLC
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Dates
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Enumeration Date | 06/13/2025
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Last Update Date | 11/17/2025
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Provider Practice Location Address
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Address Line | 10841 SPRING GREEN DR
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City | INDIANAPOLIS
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State | IN
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Zip | 46229-3535
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Country | US
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Telephone | 317-869-7887
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Fax |
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Provider Business Mailing Address
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Address Line | 5625 SUNNYSIDE ROAD 3235
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City | INDIANAPOLIS
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State | IN
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Zip | 46235
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Country | US
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Telephone |
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Fax |
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Authorized Official
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Title or Position | CEO
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Name | DEMIA WHITE
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Credential |
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Telephone | 317-333-1927
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 251E00000X
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Taxonomy Name | Home Health Agency
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License Number |
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License Number State |
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