Magnolia Fields Afch LLC

Primary specialty

Assisted Living FacilityTaxonomy code 310400000X

Legal business name

MAGNOLIA FIELDS AFCH LLC

Practice address

11309 Chilly Water CT
Riverview, FL 33569-2059

Phone

(813) 507-5878

NPI assigned

Jun 8, 2022

Organization subpart

No

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

Authorized official

Name

Alaysha ClarkNPI 1083352215

Title

Director/Ceo

Phone

(813) 507-5878

Specialties & licenses 1

Addresses

Practitioners 1

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

• Alaysha Clark

  • Adult Care Home Facility
  • Riverview, FL
  • NPI 1083352215

  Assisted Living Facility

  NPD Authorized official

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

{
    "created_epoch": "1654646400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1654646400000",
    "number": "1467181925",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "11309 CHILLY WATER CT",
            "city": "RIVERVIEW",
            "state": "FL",
            "postal_code": "335692059"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "11309 CHILLY WATER CT",
            "city": "RIVERVIEW",
            "state": "FL",
            "postal_code": "335692059",
            "telephone_number": "813-507-5878"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "MAGNOLIA FIELDS AFCH LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2022-06-08",
        "last_updated": "2022-06-08",
        "certification_date": "2022-06-08",
        "status": "A",
        "authorized_official_last_name": "CLARK",
        "authorized_official_first_name": "ALAYSHA",
        "authorized_official_title_or_position": "DIRECTOR/CEO",
        "authorized_official_telephone_number": "813-507-5878"
    },
    "taxonomies": [
        {
            "code": "310400000X",
            "taxonomy_group": "",
            "desc": "Assisted Living Facility",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Jenny Edwards Lynn, DMD
• William Joachim Macisaac, L.M.T.
• Amy Macrae
• Cheryl Maddox
• Arlindo Abreu Madeira, P.T.
• Kim Marie Maguire, M.D., MPT
• Gia Maher
• Teryeshia Mahogany
• Steven B Maines
• Alexis Maki, BT

• Assisted Living Facility in Riverview, FL
• Providers in Riverview, FL by specialty
• Assisted Living Facility in Florida

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 8, 2022; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.