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) | Code | License | State | Primary |
|---|---|---|---|---|
| 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
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- Dominique King
- Tony Roosevelt King
- Cory Andrew Lane
- Loving Hands Homecare LLC
- Tera N Moore
- More Wellness Medical Clinic LLC
- Shawana Roach
- Tyesha Shaw
- Southern Living Child Care LLC
All providers in Disputanta, VA · Intellectual and/or Developmental Disabilities Residential Treatment Facility in Virginia
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Feb 13, 2013. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.