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General NPI Number Information
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NPI Number | 1659327708
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Entity Type | Organization
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Legal Business Name | MAGNOLIA VILLAGE RETIREMENT COMMUNITY, LTD
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Dates
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Enumeration Date | 05/26/2006
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Last Update Date | 04/11/2014
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Provider Practice Location Address
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Address Line | 365 JOHNSON RD
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City | WADSWORTH
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State | OH
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Zip | 44281-8609
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Country | US
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Telephone | 330-335-1558
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Fax |
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Provider Business Mailing Address
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Address Line | 365 JOHNSON RD
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City | WADSWORTH
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State | OH
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Zip | 44281-8609
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Country | US
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Telephone | 330-335-1558
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Fax | 330-335-2519
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Authorized Official
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Title or Position | PRES., VRC, INC MANAGER
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Name | MICHAEL J FRANCUS
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Credential |
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Telephone | 330-929-0009
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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 |
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License Number State |
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