MEDICARE: THE MAGNOLIA HOME LLC

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	310400000X	Assisted Living Facility

General Provider Information

NPI Number	:	1134967235
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	THE MAGNOLIA HOME LLC

Provider Business Mailing Address
First Line	:	6707 SAUSALITO AVE
Second Line	:
City	:	WEST HILLS
State	:	CA
Zip	:	91307-3722
Country	:	US
Telephone Number	:	661-236-6787
Fax Number	:

Provider Business Practice Location Address
First Line	:	6707 SAUSALITO AVE
Second Line	:
City	:	WEST HILLS
State	:	CA
Zip	:	91307-3722
Country	:	US
Telephone Number	:	661-236-6787
Fax Number	:

Authorized Official
Title or Position	:	ADMINISTRATOR
Name	:	UKARJIT KAUR
Credential	:
Telephone Number	:	661-236-6787

Provider Enumeration Date	:	07/15/2024
Last Update Date	:	07/15/2024

Similar Medicare Providers

1497832083 — DR. LYSA CHARLES MD
Practice Location Address:

2101 E JEFFERSON ST PPQA MEDICARE COMPLIANCE UNT 6 WEST , KAISER PERMANENTE MID ATLANTIC PERMANENTE MEDICAL GROUP
ROCKVILLE, MD
20852-4908

Practice Phone: 301-816-6660
Practice Fax: 301-816-6308

1194114876 — BRIAN LIMAS PT
Practice Location Address:

6721 SAUSALITO AVE
WEST HILLS, CA
91307-3722

Practice Phone: 626-429-5007
Practice Fax:

1548201882 — CITY OF NEW YORK OFFICE OF PAYROLL ADMINISTRATION
Practice Location Address:

600 WEST 168TH STREET , NYCDOHMH WASHINGTON HEIGHTS DHC
NEW YORK, NY
10032-3722

Practice Phone: 212-368-4300
Practice Fax: 212-694-7187

1124150990 — MARK JEFF MCNOWN D.C.
Practice Location Address:

390 WEST ST
HOLLISTER, CA
95023-3722

Practice Phone: 831-637-0081
Practice Fax:

1427341551 — FIRAS SALEM AHMED MD
Practice Location Address:

622 WEST 168TH STREET
NEW YORK, NY
10032-3722

Practice Phone: 212-305-9022
Practice Fax:

1205254463 — ANNE NILES
Practice Location Address:

83 WEST ST
NORTHAMPTON, MA
01060-3722

Practice Phone: 413-586-5818
Practice Fax:

Directions to “THE MAGNOLIA HOME LLC ” Practice Location

Language	Start Address	Practice Location

These directions are for planning purposes only. You may find that construction projects, traffic, or other events may cause road conditions to differ from the map results.

Copyright © 2007-2026 (Powered by Swiss Vault Engine), all rights reserved. HIPAA liability, trademark, document use and software licensing rules apply. All registered trademarks, used in the content, are the property of their owners. Your interactions with this site are in accordance with our Terms of Use and Privacy Policy.