NPIMap

Organization Active NPI

Magnolia Family Services LLC

  • Community/Behavioral Health Agency
  • Thibodaux, LA
National Provider Identifier
1508982455
Registry record updated Jun 8, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Community/Behavioral Health AgencyTaxonomy code 251S00000X
License
1176621 Issued in LA
Legal business name
MAGNOLIA FAMILY SERVICES LLC
Practice address
1418 Tiger Dr
Thibodaux, LA 70301-4337
Phone
(985) 449-4055
Fax
(985) 449-4178
NPI assigned
Mar 22, 2007
Last updated
Jun 8, 2023By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jun 8, 2023

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

Authorized official

Name
Mr. Donald B Olivier II, MBA
Title
Ceo
Phone
(985) 449-4055

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Mental Health Clinic/Center (Including Community Mental Health Center) 261QM0801X NU
Community/Behavioral Health Agency 251S00000X 1176621 LA Primary

Addresses

Primary practice location

1418 Tiger Dr
Thibodaux, LA 70301-4337

Mailing address

1418 Tiger Dr
Thibodaux, LA 70301-4337
Phone (985) 449-4055

Other identifiers 2

IdentifierTypeStateIssuer
1176621MedicaidLA
600720425OtherLAMAGELLAN HEALTH SERVICES

National Provider Directory

National Provider Directory

Locations

106 Hickory St
Thibodaux, LA 70301
Phone (985) 446-4114

Practitioners & affiliated clinicians

Practitioners 96

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

View all 96

NPI Registry JSON

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

{
    "created_epoch": "1174521600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1686182400000",
    "number": "1508982455",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1418 TIGER DR",
            "city": "THIBODAUX",
            "state": "LA",
            "postal_code": "703014337",
            "telephone_number": "985-449-4055",
            "fax_number": "985-449-4178"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1418 TIGER DR",
            "city": "THIBODAUX",
            "state": "LA",
            "postal_code": "703014337",
            "telephone_number": "985-449-4055",
            "fax_number": "985-449-4178"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "MAGNOLIA FAMILY SERVICES LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-03-22",
        "last_updated": "2023-06-08",
        "certification_date": "2023-06-08",
        "status": "A",
        "authorized_official_last_name": "OLIVIER",
        "authorized_official_first_name": "DONALD",
        "authorized_official_middle_name": "B",
        "authorized_official_title_or_position": "CEO",
        "authorized_official_telephone_number": "985-449-4055",
        "authorized_official_name_prefix": "Mr.",
        "authorized_official_name_suffix": "II",
        "authorized_official_credential": "MBA"
    },
    "taxonomies": [
        {
            "code": "261QM0801X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Mental Health (Including Community Mental Health Center)",
            "state": "NU",
            "license": null,
            "primary": false
        },
        {
            "code": "251S00000X",
            "taxonomy_group": "",
            "desc": "Community/Behavioral Health",
            "state": "LA",
            "license": "1176621",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1176621",
            "state": "LA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MAGELLAN HEALTH SERVICES",
            "identifier": "600720425",
            "state": "LA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Thibodaux, LA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 8, 2023; 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.