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General NPI Number Information
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NPI Number | 1194259184
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Entity Type | Organization
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Legal Business Name | MAGNOLIA HOME CARE SERVICES
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Dates
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Enumeration Date | 04/17/2017
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Last Update Date | 04/17/2017
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Provider Practice Location Address
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Address Line | 1307 BUTTERFIELD RD SUITE # 416
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City | DOWNERS GROVE
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State | IL
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Zip | 60515-5606
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Country | US
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Telephone | 331-903-0693
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Fax | 630-206-0693
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Provider Business Mailing Address
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Address Line | 1307 BUTTERFIELD RD SUITE # 416
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City | DOWNERS GROVE
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State | IL
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Zip | 60515-5606
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Country | US
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Telephone | 331-903-0693
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Fax | 630-206-0693
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Authorized Official
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Title or Position | OWNER
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Name | ABIDEMI FIJABI
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Credential |
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Telephone | 331-903-0693
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 253Z00000X
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Taxonomy Name | In Home Supportive Care Agency
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License Number |
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License Number State |
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