| Organization Name: | MAGNOLIA GARDENS ASSISTED LIVING |
| NPI Number: | 1336331685 |
| Entity Type Code: | Organizational (2) |
| Authorized Official Name: | DEBORAH DARLENE STEVERSON (OWNER/ADMINISTRATOR) |
| Mailing Address: | 945 West Dr Laurel |
| State: | MS US |
| Postal Code: | 394404703 |
| Phone Number: | 6016496660 |
| Fax Number: | 6014284685 |
| NPI Enumeration Date: | 08/10/2007 |
| NPI Last Update Date: | 08/10/2007 |
| Replacement NPI: | 0 |
| NPI Deactivation Date: | |
| NPI Reactivation Date: |
Taxonomy Information: | |
| Healthcare Provider Taxonomy: | 347C00000X |
| License Number: | 898 |
| Healthcare Provider Taxonomy: (Secondary) | N |
| State: | MS |
| Taxonomy Type: | Transportation Services |
| Taxonomy Classification: | Private Vehicle |
| Taxonomy Specialization: | |
| Taxonomy Definition: | An individual paid to provide non-emergency transportation using their privately owned/leased vehicle. |