Magnolia Behavioral Health, Inc.

Primary specialty

Adolescent and Children Mental Health Clinic/CenterTaxonomy code 261QM0855X

Legal business name

MAGNOLIA BEHAVIORAL HEALTH, INC.

Practice address

3350 Northlake Pkwy NE
Atlanta, GA 30345-2204

Phone

(770) 724-8093

NPI assigned

Jan 4, 2013

Last updated

Jan 4, 2013By the provider in NPPES

Organization subpart

No

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

Authorized official

Name

Dr. Mira Mira Iheme, PH.D.

Title

President

Phone

(770) 724-8093

Specialties & licenses 1

Addresses

Tax ID family

Magnolia Behavioral Health Inc2 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.

• Magnolia Health Clinic

  • Primary Care Clinic/Center
  • Atlanta, GA
  • NPI 1487047049
  NPD tax ID

Locations

Subparts reporting this organization as parent 1

Organizations that report themselves as subparts in NPPES and name this organization, in the same state, as their parent.

• Magnolia Health Clinic

  • Primary Care Clinic/Center
  • Atlanta, GA
  • NPI 1487047049
  NPPES parent name

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

{
    "created_epoch": "1357257600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1357257600000",
    "number": "1730426198",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3350 NORTHLAKE PKWY NE",
            "city": "ATLANTA",
            "state": "GA",
            "postal_code": "303452204",
            "telephone_number": "770-724-8093"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3350 NORTHLAKE PKWY NE",
            "city": "ATLANTA",
            "state": "GA",
            "postal_code": "303452204",
            "telephone_number": "770-724-8093"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "MAGNOLIA BEHAVIORAL HEALTH, INC.",
        "organizational_subpart": "NO",
        "enumeration_date": "2013-01-04",
        "last_updated": "2013-01-04",
        "status": "A",
        "authorized_official_last_name": "IHEME",
        "authorized_official_first_name": "MIRA",
        "authorized_official_middle_name": "MIRA",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "770-724-8093",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "PH.D."
    },
    "taxonomies": [
        {
            "code": "261QM0855X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Adolescent and Children Mental Health",
            "state": "GA",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Shelley S Magill, M.D., PH.D.
• William H Magill, LCSW
• Caleb Magistro, AGNP-C
• Nazario Maglanque II, PT
• Martin Lazcano Magnaye
• Magnolia Health Clinic
• Magnolia Physical Therapy and Wellness
• Magnolias and Memories Homecare LLC
• Lorna Nicolette Magnus, LPC
• Reena Anala Mahabir, EDM

• Adolescent and Children Mental Health Clinic/Center in Atlanta, GA
• Providers in Atlanta, GA by specialty
• Adolescent and Children Mental Health Clinic/Center in Georgia

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 4, 2013; 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.