Organization Name: | MAGNOLIA HOSPICE OF THE DELTA, LLC |
NPI Number: | 1659736460 |
Entity Type Code: | Organizational (2) |
Authorized Official Name: | ERIN BOLTON (DIRECTOR OF COMPLIANCE) |
Mailing Address: | 12120 Colonel Glenn Rd Suite 10,000 Little Rock |
State: | AR US |
Postal Code: | 722102824 |
Phone Number: | 8705400727 |
Fax Number: | |
NPI Enumeration Date: | 12/21/2015 |
NPI Last Update Date: | 12/21/2015 |
Replacement NPI: | 0 |
NPI Deactivation Date: | |
NPI Reactivation Date: |
Taxonomy Information: | |
Healthcare Provider Taxonomy: | 251G00000X |
License Number: | |
Healthcare Provider Taxonomy: (Secondary) | Y |
State: | |
Taxonomy Type: | Agencies |
Taxonomy Classification: | Hospice Care, Community Based |
Taxonomy Specialization: | |
Taxonomy Definition: |