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NPI Code Detail

MEDICARE: MAGNOLIA RIDGE CARE & REHABILITATION LLC

MEDICARE: MAGNOLIA RIDGE CARE & REHABILITATION 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
1314000000XSkilled Nursing Facility

General Provider Information

NPI Number : 1477405710
Entity Type Code : Organization
Provider Name (Legal Business Name) : MAGNOLIA RIDGE CARE & REHABILITATION LLC
Provider Business Mailing Address
First Line : 1105 S SUNSWEPT ST
Second Line :
City : UNION CITY
State : TN
Zip : 38261-4370
Country : US
Telephone Number :
Fax Number :
Provider Business Practice Location Address
First Line : 1105 S SUNSWEPT ST
Second Line :
City : UNION CITY
State : TN
Zip : 38261-4370
Country : US
Telephone Number : 731-885-6400
Fax Number :
Authorized Official
Title or Position : MANAGER
Name : AARON CHESLEY
Credential :
Telephone Number : 949-338-9060
Provider Enumeration Date : 02/10/2026
Last Update Date : 02/10/2026

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Directions to “MAGNOLIA RIDGE CARE & REHABILITATION LLC ” Practice Location

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