Magnolia Health Systems 49, LLC

Primary specialty

Assisted Living FacilityTaxonomy code 310400000X

License

15-013401-1 Issued in IN

Legal business name

MAGNOLIA HEALTH SYSTEMS 49, LLC

Practice address

2009 N Hospital Blvd
Sullivan, IN 47882-7658

Phone

(812) 268-2000

Fax

(812) 268-2080

NPI assigned

Nov 11, 2015

Organization subpart

No

Name

Stuart Reed

Title

Member

Phone

(317) 818-1240

These CMS records do not include an NPI. They are shown because their name and street address match this provider’s.

CLIA laboratory certificates

• BRECKENRIDGE COMMONS RESIDENTIAL FACILITY Doing business as

The complete NPPES record for this NPI in the NPI Registry API format, last updated by the provider on Jul 15, 2024.

{
    "created_epoch": "1447200000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1721001600000",
    "number": "1730552811",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "8455 KEYSTONE XING",
            "city": "INDIANAPOLIS",
            "state": "IN",
            "postal_code": "462404353",
            "telephone_number": "317-818-1240",
            "fax_number": "317-818-0720"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2009 N HOSPITAL BLVD",
            "city": "SULLIVAN",
            "state": "IN",
            "postal_code": "478827658",
            "telephone_number": "812-268-2000",
            "fax_number": "812-268-2080"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "MAGNOLIA HEALTH SYSTEMS 49, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2015-11-11",
        "last_updated": "2024-07-15",
        "certification_date": "2024-07-15",
        "status": "A",
        "authorized_official_last_name": "REED",
        "authorized_official_first_name": "STUART",
        "authorized_official_title_or_position": "MEMBER",
        "authorized_official_telephone_number": "317-818-1240"
    },
    "taxonomies": [
        {
            "code": "310400000X",
            "taxonomy_group": "",
            "desc": "Assisted Living Facility",
            "state": "IN",
            "license": "15-013401-1",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "INDIANA STATE DEPARTMENT OF HEALTH LICENSE",
            "identifier": "15-013401-1",
            "state": "IN"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "BRECKENRIDGE COMMONS RESIDENTIAL FACILITY",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

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• Mary Ann Chavez DO PC
• Amanda Matthews-Hargrave, LMHC, LCAC
• Medlife Inc

• All providers in Sullivan, IN
• Assisted Living Facility in Indiana

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 15, 2024; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.