MAGNOLIA MANOR ASSISTED LIVING, INC. (NPI# 1982951067) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1982951067 |
| Entity Type | Organization |
| Organization Name | MAGNOLIA MANOR ASSISTED LIVING, INC. |
| Practice Address |
17420 Old Tobacco Rd Lutz FL 33558-4979 |
| Practice Telephone | 8139180588 |
| Enumeration Date | 2012-08-08 |
| Last Update Date | 2012-08-08 |
| Authorized Official Name | BARBARA KEITHLY (PRESIDENT) |
| Authorized Official Telephone | 8139180588 |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 310400000X | Assisted Living Facility | AL12096 | FL | Nursing & Custodial Care Facilities |
| Street Address |
17420 OLD TOBACCO RD |
| City | LUTZ |
| State | FL |
| Zip Code | 33558-4979 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1801353792 | Oral Maxillofacial and Implant Specialists, LLC | Dentist | 4675 Van Dyke Rd., Lutz, FL 33558 | 2019-02-27 |
| 1780175273 | Elder Services of Central Florida, Inc | Home Health | 17901 Hunting Bow Cir Ste 101, Lutz, FL 33558 | 2018-05-21 |
| 1356843106 | Physicial Medicine & Rehab Consultants | Clinic/Center | 18865 State Road 54 Ste 301, Lutz, FL 33558 | 2018-03-07 |
| 1376905851 | Michelle Renee Story | Contractor | 20921 Haulover Cv. #f6, Lutz, FL 33558 | 2016-03-24 |
| 1992192223 | Melissa Sonia Giblin | Specialist/Technologist, Other | 17535 Darby Ln, Lutz, FL 33558 | 2015-04-24 |
| 1396177739 | Zoe Scripts Laboratory Services LLC | Clinical Medical Laboratory | 4969 Van Dyke Rd., Lutz, FL 33558 | 2013-08-08 |
| 1649617705 | Suzanne Marie Newby | Physician Assistant | 16541 Pointe Village Dr Ste 209, Lutz, FL 33558 | 2013-05-30 |
| 1073889572 | Julie J. Mckean, Lmhc, Ncc, LLC | Counselor | 4929 Van Dyke Road, Lutz, FL 33558 | 2012-03-29 |
| 1750524864 | Sheetal Suryawanshi | Dentist | 17735 Hunting Bow Circle, Lutz, Florida, FL 33558 | 2009-04-20 |
| 1063675478 | Juan J Egas | Physical Medicine & Rehabilitation | 17807 Hunting Bow Cir, Lutz, FL 33558 | 2008-07-07 |
| Find all providers in zip 33558 | ||||
| Taxonomy Code | 310400000X |
| Grouping | Nursing & Custodial Care Facilities |
| Classification | Assisted Living Facility |
| A facility providing supportive services to individuals who can function independently in most areas of activity, but need assistance and/or monitoring to assure safety and well being. |
| Notes: [7/1/2003: new] |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1730631284 | Angels Senior Living At The Lodges of Idlewild, LLC | Assisted Living Facility | 18440 Exciting Idlewild Blvd, Lutz, FL 33548-4573 | 2016-11-01 |
| 1255723474 | Jenny;s Alf 3,inc | Assisted Living Facility | 17633 Meadowbridge Dr, Lutz, FL 33549-5574 | 2015-02-25 |
| 1831511120 | Stephanie Wells | Assisted Living Facility | 1114 W County Line Rd, Lutz, FL 33558-5032 | 2014-01-06 |
| 1306276381 | The Austin Group Inc | Assisted Living Facility | 1011 Van Dyke Rd, Lutz, FL 33548-4719 | 2013-11-12 |
| 1164705901 | Jenny's Assisted Living Facility | Assisted Living Facility | 16116 Tampa St, Lutz, FL 33548-6125 | 2011-09-27 |
| 1609235597 | Villa's Alf #2, Inc. | Assisted Living Facility | 16116 Tampa St, Lutz, FL 33548-6125 | 2016-02-19 |
| 1114390101 | Wellness Care Center LLC | Assisted Living Facility | 17633 Meadowbridge Dr, Lutz, FL 33549-5574 | 2015-11-12 |
| 1700260387 | Gloria Alf, Inc. | Assisted Living Facility | 16116 Tampa St, Lutz, FL 33548-6125 | 2015-07-14 |
| 1780070078 | Gomes Place LLC | Assisted Living Facility | 17607 Simmons Rd, Lutz, FL 33548-4596 | 2015-04-13 |
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|---|---|---|---|---|
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| 1548861230 | Allure A&l Inc | Assisted Living Facility | 13692 Carlton St, Wellington, FL 33414-7748 | 2020-11-08 |
| 1982205787 | Pd & Sr, L.L.C. | Assisted Living Facility | 730 Frisco St Se, Palm Bay, FL 32909-3711 | 2020-11-06 |
| 1982205019 | Cantillo Love & Care LLC | Assisted Living Facility | 1045 W 23rd St, Hialeah, FL 33010-1922 | 2020-11-04 |
| 1194326728 | Bliss Life Residential Care | Assisted Living Facility | 402 Arthur Ave, Lehigh Acres, FL 33936-7412 | 2020-11-02 |
| 1811597404 | Huguette Mortimer Dupont | Assisted Living Facility | 1596 Sw Paar Dr, Port St Lucie, FL 34953-6159 | 2020-11-01 |
| 1750981841 | Senior Living Properties IIi, LLC | Assisted Living Facility | 3791 Old Canoe Creek Rd, Saint Cloud, FL 34769-6630 | 2020-10-28 |
| 1417556028 | 5081 Cambridge LLC | Assisted Living Facility | 5081 Nw Dunn Rd, Fort Pierce, FL 34981-4942 | 2020-10-23 |
| 1134728926 | Pacifica Lauderhill LLC | Assisted Living Facility | 5500 Nw 69th Ave, Lauderhill, FL 33319-7266 | 2020-10-22 |
| 1760081749 | Hsre-ahr Zephyrhills LLC | Assisted Living Facility | 38130 Pretty Pond Road, Zephyrhills, FL 33540 | 2020-10-21 |
| Find all providers with the same taxonomy | ||||
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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.