Magnolia Manor Management Inc

Primary specialty

Skilled Nursing FacilityTaxonomy code 314000000X

Legal business name

MAGNOLIA MANOR MANAGEMENT INC

Doing business as

Magnolia Manor

Practice address

510 E Bonham St
Jefferson, TX 75657-1506

Phone

(903) 665-3903

Fax

(903) 665-2410

NPI assigned

Jul 24, 2007

Organization subpart

No

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

Authorized official

Name

Mr. Wayne Powell

Title

Director

Phone

(469) 293-0002

Specialties & licenses 1

Addresses

Other names 1

• Magnolia Manor Doing business as

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

{
    "created_epoch": "1185235200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1185235200000",
    "number": "1639379902",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "510 E BONHAM ST",
            "city": "JEFFERSON",
            "state": "TX",
            "postal_code": "756571506",
            "telephone_number": "903-665-3903",
            "fax_number": "903-665-2410"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "510 E BONHAM ST",
            "city": "JEFFERSON",
            "state": "TX",
            "postal_code": "756571506",
            "telephone_number": "903-665-3903",
            "fax_number": "903-665-2410"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "MAGNOLIA MANOR MANAGEMENT INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-07-24",
        "last_updated": "2007-07-24",
        "status": "A",
        "authorized_official_last_name": "POWELL",
        "authorized_official_first_name": "WAYNE",
        "authorized_official_title_or_position": "DIRECTOR",
        "authorized_official_telephone_number": "469-293-0002",
        "authorized_official_name_prefix": "Mr."
    },
    "taxonomies": [
        {
            "code": "314000000X",
            "taxonomy_group": "",
            "desc": "Skilled Nursing Facility",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Magnolia Manor",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

• Lindsay Lloyd
• Angela Dawn Long
• Jennifer Lynn Lopez
• Andrew Blake Lummus
• Crista Rae Lumpkin
• Ariel Anastashia Malone
• Marion County Management Company (Magnolia Manor Nursing Home)
• Amber Nicole Mark
• Justin Luke Marsh
• Marshall Physical Therapy, Inc

• Skilled Nursing Facility in Jefferson, TX
• Providers in Jefferson, TX by specialty
• Skilled Nursing Facility in Texas

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 24, 2007; 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.