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General NPI Number Information
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NPI Number | 1700745643
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Entity Type | Organization
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Legal Business Name | GILDEN MAGNOLIA LIFE CARE LLC
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Dates
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Enumeration Date | 01/16/2026
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Last Update Date | 01/16/2026
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Provider Practice Location Address
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Address Line | 634 31ST AVE N APT 79
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City | COLUMBUS
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State | MS
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Zip | 39705-1833
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Country | US
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Telephone | 662-368-8105
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Fax | 317-455-4088
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Provider Business Mailing Address
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Address Line | 634 31ST AVE N APT 79
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City | COLUMBUS
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State | MS
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Zip | 39705-1833
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Country | US
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Telephone | 662-368-8105
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Fax | 317-455-4088
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Authorized Official
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Title or Position | DIRECTOR
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Name | MECHELANIE WILLIAMS
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Credential |
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Telephone | 662-368-8105
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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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