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General NPI Number Information
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NPI Number | 1912896556
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Entity Type | Organization
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Legal Business Name | MAGNOLIA HOUSE LLC
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Dates
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Enumeration Date | 06/30/2025
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Last Update Date | 08/26/2025
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Provider Practice Location Address
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Address Line | 1907 SOUTH DR
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City | NATCHITOCHES
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State | LA
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Zip | 71457-2654
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Country | US
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Telephone | 225-387-1611
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Fax | 225-343-5300
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Provider Business Mailing Address
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Address Line | 150 CORA DR
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City | BATON ROUGE
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State | LA
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Zip | 70815-4201
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Country | US
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Telephone | 225-387-1611
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Fax |
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Authorized Official
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Title or Position | FINANCIAL OFFICE MANAGER
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Name | ANGELA NICOLE BADEAUX
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Credential |
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Telephone | 225-387-1611
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 276400000X
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Taxonomy Name | Substance Use Disorder Rehabilitation Hospital Unit
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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 | 324500000X
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Taxonomy Name | Substance Abuse Rehabilitation Facility
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License Number |
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License Number State |
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