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General NPI Number Information
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NPI Number | 1952298952
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Entity Type | Organization
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Legal Business Name | MAGNOLIA HOME HEALTH CARE GROUP
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Dates
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Enumeration Date | 06/23/2025
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Last Update Date | 06/23/2025
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Provider Practice Location Address
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Address Line | 49 W KRAFT AVE
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City | N LAS VEGAS
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State | NV
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Zip | 89031-2596
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Country | US
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Telephone | 702-682-9750
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Fax |
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Provider Business Mailing Address
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Address Line | 49 W KRAFT AVE
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City | N LAS VEGAS
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State | NV
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Zip | 89031-2596
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Country | US
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Telephone | 702-682-9750
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Fax |
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Authorized Official
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Title or Position | ADMINISTRATOR
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Name | MARTHA C MOQUETE
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Credential |
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Telephone | 702-682-9750
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 251B00000X
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Taxonomy Name | Case Management Agency
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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 | 310400000X
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Taxonomy Name | Assisted Living Facility
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License Number |
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License Number State |
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Taxonomy #3
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Taxonomy Code | 311ZA0620X
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Taxonomy Name | Adult Care Home Facility
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License Number |
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License Number State |
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Taxonomy #4
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Taxonomy Code | 385H00000X
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Taxonomy Name | Respite Care
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License Number |
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License Number State |
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Taxonomy #5
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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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