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General NPI Number Information
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NPI Number | 1477566024
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Entity Type | Organization
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Legal Business Name | MAGNOLIA SPECIAL CARE CENTER INC
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Dates
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Enumeration Date | 08/14/2006
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Last Update Date | 02/07/2014
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Provider Practice Location Address
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Address Line | 635 S MAGNOLIA AVE
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City | EL CAJON
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State | CA
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Zip | 92020-6012
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Country | US
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Telephone | 619-442-8826
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Fax | 619-442-0288
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Provider Business Mailing Address
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Address Line | 635 S MAGNOLIA AVE
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City | EL CAJON
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State | CA
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Zip | 92020-6012
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Country | US
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Telephone | 619-442-8826
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Fax | 619-442-0288
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Authorized Official
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Title or Position | CHIEF LEGAL COUNSEL
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Name | MS. MARY PATRICIA MILLER
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Credential |
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Telephone | 619-441-8771
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 314000000X
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Taxonomy Name | Skilled Nursing Facility
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License Number | 090000072
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License Number State | CA
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