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General NPI Number Information
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NPI Number | 1891324042
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Entity Type | Organization
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Legal Business Name | MAGNOLIA HOME HEALTH, LLC DBA HOME INSTEAD SENIOR CARE
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Dates
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Enumeration Date | 04/08/2020
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Last Update Date | 04/08/2020
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Provider Practice Location Address
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Address Line | 6709 FOREST PARK DRIVE, SUITE B
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City | SAVANNAH
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State | GA
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Zip | 31406
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Country | US
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Telephone | 912-355-0099
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Fax | 912-355-0181
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Provider Business Mailing Address
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Address Line | 6709 FOREST PARK DRIVE, SUITE B
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City | SAVANNAH
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State | GA
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Zip | 31406
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Country | US
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Telephone | 912-355-0099
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Fax | 912-355-0181
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Authorized Official
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Title or Position | CO-OWNER/PRESIDENT
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Name | SHANE THOMPSON
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Credential |
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Telephone | 904-502-5990
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 376J00000X
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Taxonomy Name | Homemaker
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License Number |
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License Number State |
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Taxonomy #2
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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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