NPIMap

Organization Active NPI

Magnolia Behavior Health Center LLC

  • Comprehensive Outpatient Rehabilitation Facility (CORF)
  • Frederick, MD
National Provider Identifier
1780468496
Registry record updated Oct 26, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Comprehensive Outpatient Rehabilitation Facility (CORF)Taxonomy code 261QR0401X
Legal business name
MAGNOLIA BEHAVIOR HEALTH CENTER LLC
Practice address
604 Solarex CT Unit 205
Frederick, MD 21703-8655
Phone
(301) 305-5731
NPI assigned
Aug 23, 2023
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Oct 26, 2023

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

Authorized official

Name
Julia Shirima
Title
Owner
Phone
(240) 919-6062

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Comprehensive Outpatient Rehabilitation Facility (CORF) 261QR0401X Primary

Addresses

Primary practice location

604 Solarex CT Unit 205
Frederick, MD 21703-8655

Mailing address

604 Solarex CT Unit 205
Frederick, MD 21703-8655
Phone (301) 305-5731

National Provider Directory

National Provider Directory
Tax ID family
Magnolia Behavior Health Center LLC12 organizations share this tax ID, including this one

Other organizations with this tax ID 11

Organizations that report the same tax identification number in the National Provider Directory.

NPI Registry JSON

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

{
    "created_epoch": "1692748800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1698278400000",
    "number": "1780468496",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "604 SOLAREX CT UNIT 205",
            "city": "FREDERICK",
            "state": "MD",
            "postal_code": "217038655",
            "telephone_number": "301-305-5731"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "604 SOLAREX CT UNIT 205",
            "city": "FREDERICK",
            "state": "MD",
            "postal_code": "217038655",
            "telephone_number": "301-305-5731"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "MAGNOLIA BEHAVIOR HEALTH CENTER LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2023-08-23",
        "last_updated": "2023-10-26",
        "certification_date": "2023-10-26",
        "status": "A",
        "authorized_official_last_name": "SHIRIMA",
        "authorized_official_first_name": "JULIA",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "240-919-6062"
    },
    "taxonomies": [
        {
            "code": "261QR0401X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Rehabilitation, Comprehensive Outpatient Rehabilitation Facility (CORF)",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Frederick, MD

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 26, 2023; 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.