MAGNOLIA DIAGONSTIC SERVICES INC. (NPI# 1821225806) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1821225806 |
| Entity Type | Organization |
| Organization Name | MAGNOLIA DIAGONSTIC SERVICES INC. |
| Other Organization Name | NO |
| Practice Address |
2005 Creswell Ave Shreveport LA 71104-2201 |
| Practice Telephone | 3186780709 |
| Mailing Telephone | 3186780709 |
| Enumeration Date | 2009-06-17 |
| Last Update Date | 2009-06-17 |
| Authorized Official Name | MR. DEWARRENT L. BRANTLEY (CEO/ PRESIDENT) |
| Authorized Official Telephone | 3186780709 |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 261QM1300X |
Clinic/Center Specialization: Multi-Specialty |
Ambulatory Health Care Facilities |
| Other Name | Type Code |
|---|---|
| no | Former Legal Business Name - Organization |
| Street Address |
2005 CRESWELL AVE |
| City | SHREVEPORT |
| State | LA |
| Zip Code | 71104-2201 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1881691194 | Magnolia Rehabiliation Services Inc | Clinic/Center | 2005 Creswell Ave, 4908 P.o.box Shreveport La .71134, Shreveport, LA 71104-2201 | 2005-06-30 |
| 1922235878 | Magnolia Transportation Services Inc. | Non-emergency Medical Transport (VAN) | 2005 Creswell Ave, Shreveport, LA 71104-2201 | 2009-06-18 |
| 1972730828 | Magnolia Intergrated Healthcare Services Inc | Pharmacy | 2005 Creswell Ave, Shreveport, LA 71104-2201 | 2009-06-18 |
| 1982652301 | Magnolia Community Mental Health Facility Inc. | Clinic/Center | 2005 Creswell Ave, Shreveport, LA 71104-2201 | 2006-05-05 |
| 1407853716 | Magnolia Comprehensive Outpatient Rehabiliation Facility Inc. | Clinic/Center | 2005 Creswell Ave, Shreveport, LA 71104-2201 | 2005-06-30 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1326582263 | Dana Jackson | Counselor | 2425 Youree Drive, Shreveport, LA 71104 | 2016-12-12 |
| 1154772929 | Belena Cawthorne | Case Manager/Care Coordinator | 2040 Southern Ave, Shreveport, LA 71104 | 2016-06-23 |
| 1437505286 | Courtney Espenan | Counselor | 3825 Gilbert Dr Ste 124, Shreveport, LA 71104 | 2016-05-11 |
| 1215390497 | Joshua Mitchell | Counselor | 1106 Dalzell Street, Shreveport, LA 71104 | 2016-04-04 |
| 1699135426 | Amy Lutricia Krohn | Counselor | 1041 Dalzell St, Shreveport, LA 71104 | 2016-03-07 |
| 1225497779 | Annie Redding II | Counselor | 2525 Youree Dr Suite 110, Shreveport, LA 71104 | 2016-02-12 |
| 1891152328 | Council On Alcoholism and Drug Abuse of Northwest Louisiana | Community/Behavioral Health | 2000 Fairfield Ave, Shreveport, LA 71104 | 2016-01-28 |
| 1922465731 | Marteze Singleton | Case Manager/Care Coordinator | 2525 Youree Dr Ste 10, Shreveport, LA 71104 | 2016-01-25 |
| 1891160297 | Damara Mora | Counselor | 2620 Centenary Blvd Bldg3 Ste 312, Shreveport, LA 71104 | 2015-12-10 |
| 1962876250 | Chastity Shermaine Graham | Counselor | 2620 Centenary Blvd Ste 312, Shreveport, LA 71104 | 2015-11-24 |
| Find all providers in zip 71104 | ||||
| Taxonomy Code | 261QM1300X |
| Grouping | Ambulatory Health Care Facilities |
| Classification | Clinic/Center |
| Specialization | Multi-Specialty |
| Definition to come... |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1437660115 | Edge Medical Services Inc. | Clinic/Center | 2100 E 70th St, Shreveport, LA 71105-5363 | 2017-10-20 |
| 1881691194 | Magnolia Rehabiliation Services Inc | Clinic/Center | 2005 Creswell Ave, 4908 P.o.box Shreveport La .71134, Shreveport, LA 71104-2201 | 2005-06-30 |
| 1912053828 | The Center for Therapy, Inc | Clinic/Center | 1800 Buckner St, Suite C-200, Shreveport, LA 71101-4440 | 2007-01-25 |
| 1386660363 | Christus Health Northern Louisiana | Clinic/Center | 1 Saint Mary Pl, Shreveport, LA 71101-4343 | 2006-07-14 |
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| 1235616194 | Pathways Addiction Recovery, LLC | Clinic/Center | 3801 Houma Blvd Ste 100, Metairie, LA 70006-4185 | 2018-07-24 |
| 1063915866 | Gulf Coast Medical Center | Clinic/Center | 51 Holmes Blvd Ste A, Terrytown, LA 70056-2592 | 2018-03-18 |
| 1912436213 | Third Hand Assisting Inc | Clinic/Center | Po Box 141, Talisheek, LA 70464-0141 | 2017-06-08 |
| Find all providers with the same taxonomy | ||||
| City | SHREVEPORT |
| Zip Code | 71104 |
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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.