Magnolia Woods, LLC

Organization Active NPI Intellectual and/or Developmental Disabilities Residential Treatment Facility · Disputanta, VA

NPI 1730428640 · NPPES record last updated Feb 13, 2013

Key facts

NPI
1730428640
Entity type
Organization (NPI type 2)
Primary specialty
Intellectual and/or Developmental Disabilities Residential Treatment Facility 320600000X
Legal business name
MAGNOLIA WOODS, LLC
Practice address
6688 Tatum Rd
Disputanta, VA 23842-6902
Phone
(804) 550-8674
NPI assigned
Feb 13, 2013
Organization subpart
No

Authorized official

Name
Mrs. Jennifer Jayne White
Title
President/Director
Phone
(804) 550-8674

National Provider Directory

Specialties & licenses

Specialty (taxonomy)CodeLicenseStatePrimary
Intellectual and/or Developmental Disabilities Residential Treatment Facility 320600000X Yes

Addresses

Primary practice location

6688 Tatum Rd
Disputanta, VA 23842-6902

Mailing address

6688 Tatum Rd
Disputanta, VA 23842-6902
Phone (804) 550-8674

Other providers in Disputanta, VA

All providers in Disputanta, VA · Intellectual and/or Developmental Disabilities Residential Treatment Facility in Virginia

Sources for this page

Verify at the official NPI Registry.