NPIMap

Organization Active NPI

Magdan LLC

  • Adult Mental Health Clinic/Center
  • Fort Myers, FL
National Provider Identifier
1609501428
Registry record updated Apr 2, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Adult Mental Health Clinic/CenterTaxonomy code 261QM0850X
Legal business name
MAGDAN LLC
Practice address
4519 Tilton CT
Fort Myers, FL 33907-1214
Phone
(239) 372-6141
NPI assigned
Jul 18, 2022
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Apr 2, 2026

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

Authorized official

Name
Edna Muchugu
Title
Manager
Phone
(239) 372-6141

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Adult Mental Health Clinic/Center 261QM0850X Primary
Substance Use Disorder Rehabilitation Clinic/Center 261QR0405X

Addresses

Primary practice location

4519 Tilton CT
Fort Myers, FL 33907-1214

Mailing address

4519 Tilton CT
Fort Myers, FL 33907-1214
Phone (239) 372-6141

Other names 2

  • Sprout Recovery Doing business as
  • Zion Healing Center Fort Myers Doing business as

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in FL

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20230831000091 FL Part B Supplier - Clinic/Group Practice 1052774528 Receives reassigned benefits from 3 practitioners
1 other NPI on this enrollment
Practice locations: Fort Myers, FL

Other NPIs on the same Medicare enrollment 1

NPIs listed together on one Medicare enrollment, typically parts of the same organization.

National Provider Directory

National Provider Directory
Tax ID family
Magdan LLC2 organizations share this tax ID, including this one

Other organizations with this tax ID 1

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

  • Magdan LLC
    • Mental Health Clinic/Center (Including Community Mental Health Center)
    • Fort Myers, FL
    • NPI 1336961739
    NPD tax ID

Practitioners & affiliated clinicians

Practitioners 6

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

NPI Registry JSON

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

{
    "created_epoch": "1658102400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1775088000000",
    "number": "1609501428",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4519 TILTON CT",
            "city": "FORT MYERS",
            "state": "FL",
            "postal_code": "339071214",
            "telephone_number": "239-372-6141"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4519 TILTON CT",
            "city": "FORT MYERS",
            "state": "FL",
            "postal_code": "339071214",
            "telephone_number": "239-372-6141"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "MAGDAN LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2022-07-18",
        "last_updated": "2026-04-02",
        "certification_date": "2026-04-02",
        "status": "A",
        "authorized_official_last_name": "MUCHUGU",
        "authorized_official_first_name": "EDNA",
        "authorized_official_title_or_position": "MANAGER",
        "authorized_official_telephone_number": "239-372-6141"
    },
    "taxonomies": [
        {
            "code": "261QM0850X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Adult Mental Health",
            "state": null,
            "license": null,
            "primary": true
        },
        {
            "code": "261QR0405X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Rehabilitation, Substance Use Disorder",
            "state": null,
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Sprout Recovery",
            "code": "3",
            "type": "Doing Business As"
        },
        {
            "organization_name": "Zion Healing Center Fort Myers",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Fort Myers, FL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 2, 2026; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.