MEDICARE: MAGNET HOMES AND COMMUNITY CENTERS

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	163WP0809X	Adult Psychiatric/Mental Health Registered Nurse

General Provider Information

NPI Number	:	1427116193
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	MAGNET HOMES AND COMMUNITY CENTERS

Provider Business Mailing Address
First Line	:	3102 ASPEN HOLLOW LN
Second Line	:
City	:	SUGAR LAND
State	:	TX
Zip	:	77479-3841
Country	:	US
Telephone Number	:	281-238-9691
Fax Number	:

Provider Business Practice Location Address
First Line	:	3102 ASPEN HOLLOW LN
Second Line	:
City	:	SUGAR LAND
State	:	TX
Zip	:	77479-3841
Country	:	US
Telephone Number	:	281-238-9691
Fax Number	:

Authorized Official
Title or Position	:	ADMINISTRATOR
Name	:	MRS. NKOLI BEATRICE IWUCHUKWU-MBONU
Credential	:	RN
Telephone Number	:	281-238-9691

Provider Enumeration Date	:	12/05/2006
Last Update Date	:	08/22/2020

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