MAGNOLIA GARDENS ASSISTED LIVING (NPI# 1336331685) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1336331685 |
| Entity Type | Organization |
| Organization Name | MAGNOLIA GARDENS ASSISTED LIVING |
| Practice Address |
945 West Dr Laurel MS 39440-4703 |
| Practice Telephone | 6016496660 |
| Practice Fax Number | 6014284685 |
| Mailing Telephone | 6016496660 |
| Mailing Fax Number | 6014284685 |
| Enumeration Date | 2007-08-10 |
| Last Update Date | 2007-08-10 |
| Authorized Official Name | MRS. DEBORAH DARLENE STEVERSON (OWNER/ADMINISTRATOR) |
| Authorized Official Telephone | 6016496660 |
| Authorized Official Credential | LPN |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| N | 347C00000X | Private Vehicle | 898 | MS | Transportation Services |
| N | 385H00000X | Respite Care | 898 | MS | Respite Care Facility |
| Y | 3104A0630X |
Assisted Living Facility Specialization: Assisted Living, Behavioral Disturbances |
898 | MS | Nursing & Custodial Care Facilities |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1891228581 | Magnolia Gardens Assisted Living | Assisted Living Facility | 303 East Ivy, Ellisville, MS 39437 | 2017-04-10 |
| Entity Type | Entity Name | Entity Address |
|---|---|---|
| Oregon Corporations, Companies and Business Names | MAGNOLIA GARDENS ASSISTED LIVING | 1425 Daugherty, Cottage Grove, OR 97424 |
| Oklahoma Business Registrations | MAGNOLIA GARDENS ASSISTED LIVING & MEMORY CARE, LLC | 3723 Fairview Industrial Dr Se Ste 270, Salem, OR 97302-0006 |
| Street Address |
945 WEST DR |
| City | LAUREL |
| State | MS |
| Zip Code | 39440-4703 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1316217367 | Magnolia Gardens Assisted Living, Inc | Assisted Living Facility | 945 West Dr, Laurel, MS 39440-4703 | 2012-01-09 |
| 1780966424 | Magnolia Gardens Assisted Living, Inc | Assisted Living Facility | 945 West Dr, Laurel, MS 39440-4703 | 2011-09-19 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1306323159 | Tender Loving Care Homecare LLC | Homemaker | 509 Central Ave Ste 224, Laurel, MS 39440 | 2018-07-24 |
| 1669837910 | Laurel Dental Properties | Dentist | 1925 Pine Belt Drive, Laurel, MS 39440 | 2015-12-30 |
| 1215282991 | South Central Regional Medical Center | Clinic/Center | 525 Wayne Drive, Laurel, MS 39440 | 2012-07-18 |
| 1568721215 | Terry Ratcliff Perkins | Counselor | 5192 Hwy 11 North, Laurel, MS 39440 | 2012-05-15 |
| 1437453057 | Alexander Milne Home for Women | Residential Treatment Facility, Mental Retardation and/or Developmental Disabilities | 616 East 19th Street, Laurel, MS 39440 | 2010-12-23 |
| 1710135629 | Jeffrey R. Moffett | Nurse Practitioner | 3115 Audubon Dr, Laurel, MS 39440 | 2008-09-04 |
| 1003096785 | Family Health Center, Inc | Obstetrics & Gynecology | 103 S. 12th Avenue, Laurel, MS 39440 | 2007-11-09 |
| 1669672143 | Laurel Urology Clinic Pa | Urology | 304 S 10th Ave, Laurel, MS 39440 | 2007-07-23 |
| 1093912370 | Tanweer Hussain Majid | Surgery | 1007 Jefferson Street, Laurel, MS 39440 | 2007-06-29 |
| 1780889923 | Hattiesburg Eye Clinic, Pa | Ophthalmology | 1431 North 10th St, Suite 1, Laurel, MS 39440 | 2007-06-18 |
| Find all providers in zip 39440 | ||||
| Taxonomy Code | 3104A0630X |
| Grouping | Nursing & Custodial Care Facilities |
| Classification | Assisted Living Facility |
| Specialization | Assisted Living, Behavioral Disturbances |
| A facility providing supportive services to individuals who can function independently in most areas of activity, but exhibit abnormal behavioral responses and habits and therefore need special guidance, assistance and/or monitoring to assure safety and well being. This type of facility requires a staff with special training in dealing with and redirecting negative, violent or destructive behaviors. |
| Notes: [7/1/2003: new] |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1669086591 | Justlikehome Supportive Living LLC | Assisted Living Facility | 9 County Road 3312, Enterprise, MS 39330-9070 | 2020-09-08 |
| 1043671704 | The Covington's Cove Assisted Living Center LLC | Assisted Living Facility | 192 Mary Magdalene Church Rd, Hattiesburg, MS 39401 | 2016-03-09 |
| 1851661938 | Saint Francis Community Services In Mississippi Inc | Assisted Living Facility | 503 Seal St, Apt #7, Picayune, MS 39466-5386 | 2012-01-06 |
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| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.