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General NPI Number Information
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NPI Number | 1942921788
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Entity Type | Organization
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Legal Business Name | MAGNOLIA HEALTH GROUP LLC
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Dates
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Enumeration Date | 09/09/2022
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Last Update Date | 03/23/2023
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Provider Practice Location Address
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Address Line | 1544 ROUTE 61 HWY S STE 6140
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City | POTTSVILLE
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State | PA
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Zip | 17901-4208
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Country | US
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Telephone | 570-990-5572
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Fax |
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Provider Business Mailing Address
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Address Line | 375 PATTON DR
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City | ORWIGSBURG
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State | PA
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Zip | 17961-1619
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Country | US
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Telephone | 570-294-6145
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Fax |
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Authorized Official
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Title or Position | OWNER
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Name | MICHAEL SOMERS
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Credential |
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Telephone | 570-900-5572
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 251E00000X
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Taxonomy Name | Home Health Agency
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License Number |
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License Number State |
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