MEDICARE: MAGNOLIA HARBOR CAREFARM

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	1041C0700X	Clinical Social Worker

General Provider Information

NPI Number	:	1184571994
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	MAGNOLIA HARBOR CAREFARM

Provider Business Mailing Address
First Line	:	9133 BRIGHT LN
Second Line	:
City	:	POWELL
State	:	TN
Zip	:	37849-2504
Country	:	US
Telephone Number	:	850-776-6297
Fax Number	:

Provider Business Practice Location Address
First Line	:	9133 BRIGHT LN
Second Line	:
City	:	POWELL
State	:	TN
Zip	:	37849-2504
Country	:	US
Telephone Number	:	850-776-6297
Fax Number	:

Authorized Official
Title or Position	:	FOUNDER & EXECUTIVE DIRECTOR
Name	:	DR. SABRINA CONKLIN
Credential	:	DSW, LCSW
Telephone Number	:	850-776-6297

Provider Enumeration Date	:	03/11/2026
Last Update Date	:	03/11/2026

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