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1316217367 NPI number — MAGNOLIA GARDENS ASSISTED LIVING, INC

NPI Number: 1316217367
Health Care Provider/Practitioner: MAGNOLIA GARDENS ASSISTED LIVING, INC

Information about “1316217367” NPI (MAGNOLIA GARDENS ASSISTED LIVING, INC) exists in 1316217367 in HTML format HTML  |  1316217367 in plain Text format TXT  |  1316217367 in PDF (Portable Document Format) PDF  |  1316217367 in an XML format XML  formats.

NPI Number : 1316217367 – JSON Data Format

                
{
  "Npi": {
    "NPI": "1316217367",
    "EntityType": "Organization",
    "ReplacementNPI": null,
    "EIN": null,
    "IsSoleProprietor": null,
    "IsOrgSubpart": "N",
    "ParentOrgLBN": null,
    "ParentOrgTIN": null,
    "OrgName": "MAGNOLIA GARDENS ASSISTED LIVING, INC",
    "LastName": null,
    "FirstName": null,
    "MiddleName": null,
    "NamePrefix": null,
    "NameSuffix": null,
    "Credential": null,
    "OtherOrgName": null,
    "OtherOrgNameTypeCode": null,
    "OtherLastName": null,
    "OtherFirstName": null,
    "OtherMiddleName": null,
    "OtherNamePrefix": null,
    "OtherNameSuffix": null,
    "OtherCredential": null,
    "OtherLastNameTypeCode": null,
    "FirstLineMailingAddress": "945 WEST DR",
    "SecondLineMailingAddress": null,
    "MailingAddressCityName": "LAUREL",
    "MailingAddressStateName": "MS",
    "MailingAddressPostalCode": "39440-4703",
    "MailingAddressCountryCode": "US",
    "MailingAddressTelephoneNumber": "601-477-9041",
    "MailingAddressFaxNumber": null,
    "FirstLinePracticeLocationAddress": "945 WEST DR",
    "SecondLinePracticeLocationAddress": null,
    "PracticeLocationAddressCityName": "LAUREL",
    "PracticeLocationAddressStateName": "MS",
    "PracticeLocationAddressPostalCode": "39440-4703",
    "PracticeLocationAddressCountryCode": "US",
    "PracticeLocationAddressTelephoneNumber": "601-477-9041",
    "PracticeLocationAddressFaxNumber": null,
    "EnumerationDate": "01/09/2012",
    "LastUpdateDate": "01/09/2012",
    "NPIDeactivationReasonCode": null,
    "NPIDeactivationReason": null,
    "NPIDeactivationDate": null,
    "NPIReactivationDate": null,
    "GenderCode": null,
    "Gender": null,
    "AuthorizedOfficialLastName": "STEVERSON",
    "AuthorizedOfficialFirstName": "DEBORAH",
    "AuthorizedOfficialMiddleName": "DARLENE",
    "AuthorizedOfficialTitle": "OWNER/DIRECTOR",
    "AuthorizedOfficialNamePrefix": "MRS.",
    "AuthorizedOfficialNameSuffix": null,
    "AuthorizedOfficialCredential": "LPN",
    "AuthorizedOfficialTelephoneNumber": "601-477-9041",
    "Taxonomies": {
      "Taxonomy": {
        "TaxonomyCode": "310400000X",
        "TaxonomyName": "Assisted Living Facility",
        "LicenseNumber": "898",
        "LicenseNumberStateCode": "MS",
        "PrimaryTaxonomySwitch": "Y"
      }
    },
    "HealthcareProviderTaxonomyGroups": null
  }
}
                
            

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