Magnolia Healthcare, Inc.

Primary specialty

Skilled Nursing FacilityTaxonomy code 314000000X

License

494 Issued in MS

Legal business name

MAGNOLIA HEALTHCARE, INC.

Doing business as

Autumn Leaves Nursing Home

Practice address

570 Solomon St
Greenville, MS 38703-2771

Phone

(662) 335-5863

Fax

(662) 335-5874

NPI assigned

Oct 11, 2006

Organization subpart

No

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name

Richard Thomas Daspit Sr.

Title

Ceo

Phone

(225) 906-4644

Specialties & licenses 1

Addresses

Other identifiers 1

Other names 1

• Autumn Leaves Nursing Home Doing business as

Medicare fee-for-service enrollment

Enrolled in MS

Enrollment records 1

Skilled nursing facility certification: CCN 255219

Legal name

MAGNOLIA HEALTHCARE, INC.

Doing business as

ARBOR WALK HEALTHCARE CENTER

Certification status

Active

Provider type (POS)

Nursing home – SNF/NF dual certification

Participating since

Jan 1, 1996

Last certification

Apr 16, 2025

Beds

60

Ownership / control type

Nonprofit Corporation

Organization structure

CorporationNon-profit

Incorporated

Aug 24, 1995 in MS

Enrollment address

570 Solomon St
Greenville, MS 38703-2771

Nursing home name

ARBOR WALK HEALTHCARE CENTER

Other NPIs with the same Medicare PAC ID 3

NPIs whose Medicare enrollments share a PECOS associate control ID (the same enrolled entity).

• Magnolia Healthcare, Inc.

  dba Riverview Nursing & Rehabilitation Center

  • Skilled Nursing Facility
  • Greenwood, MS
  • NPI 1265569875

  9638265531

  Same PAC ID
• Magnolia Healthcare, Inc.

  dba Haven Hall Healthcare Center

  • Skilled Nursing Facility
  • Brookhaven, MS
  • NPI 1437247780

  9638265531

  Same PAC ID
• Magnolia Healthcare, Inc.

  • Skilled Nursing Facility
  • Greenville, MS
  • NPI 1609964220

  9638265531

  Same PAC ID

Listed as

Arbor Walk Healthcare CenterCCN 255219 · All quality measures

Overall star rating

2 of 5

Health inspections

2 of 5

Staffing

3 of 5

Quality measures

2 of 5

Type

Medicare and Medicaid

Ownership

Non profit - Corporation

Certified

Jan 1, 1996

Medicare certification status

ActiveFrom the Provider of Services file

Certified beds

6055.3 residents per day on average

Abuse citation

Cited for abuse (Care Compare abuse icon)

Penalties (3 years)

2Fines totaling $8,165

Processed by Care Compare on Aug 1, 2026.

These CMS records do not include an NPI. They are shown because their name and street address match this provider’s.

CLIA laboratory certificates

Tax ID family

Arnold Avenue Nursing Home4 organizations share this tax ID, including this one

Other organizations with this tax ID 3

Organizations that report the same tax identification number in the National Provider Directory.

• Magnolia Healthcare, Inc.

  dba Riverview Nursing & Rehabilitation Center

  • Skilled Nursing Facility
  • Greenwood, MS
  • NPI 1265569875
  NPD tax ID
• Magnolia Healthcare, Inc.

  dba Haven Hall Healthcare Center

  • Skilled Nursing Facility
  • Brookhaven, MS
  • NPI 1437247780
  NPD tax ID
• Magnolia Healthcare, Inc.

  • Skilled Nursing Facility
  • Greenville, MS
  • NPI 1609964220
  NPD tax ID

Locations

All disclosed owners & managing parties 5

As disclosed on the Medicare enrollment (CMS All Owners files). Individuals include officers, directors and managing employees, who may not hold ownership.

Owners & managing parties with NPI records 1

Owners and managing parties disclosed on this facility’s Medicare enrollment that are themselves Medicare-enrolled.

• Cole Timmons Hodges, D.O.

  • Emergency Medicine Physician
  • Brookhaven, MS
  • NPI 1932517562

  Adp of the SNF

  CMS ownership

Practitioners 2

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

• Cole Timmons Hodges, D.O.

  • Emergency Medicine Physician
  • Brookhaven, MS
  • NPI 1932517562
  NPD (past)
• Parvez Karim, M.D.

  • Internal Medicine Physician
  • Greenville, MS
  • NPI 1275562464
  NPD (past)

Affiliated clinicians 2

Clinicians who list this facility as an affiliation in Medicare Care Compare.

• Cole Timmons Hodges, D.O.

  • Emergency Medicine Physician
  • Brookhaven, MS
  • NPI 1932517562

  Nursing home

  Care Compare affiliation
• Parvez Karim, M.D.

  • Internal Medicine Physician
  • Greenville, MS
  • NPI 1275562464

  Nursing home

  Care Compare affiliation

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1160524800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1568160000000",
    "number": "1164510475",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 40018",
            "city": "BATON ROUGE",
            "state": "LA",
            "postal_code": "708350018",
            "telephone_number": "225-753-0864",
            "fax_number": "225-753-0948"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "570 SOLOMON ST",
            "city": "GREENVILLE",
            "state": "MS",
            "postal_code": "387032771",
            "telephone_number": "662-335-5863",
            "fax_number": "662-335-5874"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "MAGNOLIA HEALTHCARE, INC.",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-10-11",
        "last_updated": "2019-09-11",
        "status": "A",
        "authorized_official_last_name": "DASPIT",
        "authorized_official_first_name": "RICHARD",
        "authorized_official_middle_name": "THOMAS",
        "authorized_official_title_or_position": "CEO",
        "authorized_official_telephone_number": "225-906-4644",
        "authorized_official_name_suffix": "Sr."
    },
    "taxonomies": [
        {
            "code": "314000000X",
            "taxonomy_group": "",
            "desc": "Skilled Nursing Facility",
            "state": "MS",
            "license": "494",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "220307",
            "state": "MS"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Autumn Leaves Nursing Home",
            "code": "3",
            "type": "Doing Business As"
        },
        {
            "organization_name": "Autumn Leaves Nursing Home",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

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• Kathleen Anne Mansour, M.D.

• Skilled Nursing Facility in Greenville, MS
• Providers in Greenville, MS by specialty
• Skilled Nursing Facility in Mississippi

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 11, 2019; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; facility enrollments, owners and changes of ownership; Provider of Services certification data.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.