Magnolia House Assisted Living Facility LLC

Primary specialty

Assisted Living FacilityTaxonomy code 310400000X

Legal business name

MAGNOLIA HOUSE ASSISTED LIVING FACILITY LLC

Practice address

103 Yacht Haven Drive
Cocoa Beach, FL 32931

Phone

(321) 543-3903

NPI assigned

Apr 20, 2015

Organization subpart

No

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

Authorized official

Name

Michael R Chapman

Title

Chief Financial Officer

Phone

(321) 543-3903

Specialties & licenses 1

Addresses

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

{
    "created_epoch": "1429488000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1429488000000",
    "number": "1811384696",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "103 YACHT HAVEN DRIVE",
            "city": "COCOA BEACH",
            "state": "FL",
            "postal_code": "32931",
            "telephone_number": "321-543-3903"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "103 YACHT HAVEN DRIVE",
            "city": "COCOA BEACH",
            "state": "FL",
            "postal_code": "32931",
            "telephone_number": "321-543-3903"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "MAGNOLIA HOUSE ASSISTED LIVING FACILITY LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2015-04-20",
        "last_updated": "2015-04-20",
        "status": "A",
        "authorized_official_last_name": "CHAPMAN",
        "authorized_official_first_name": "MICHAEL",
        "authorized_official_middle_name": "R",
        "authorized_official_title_or_position": "CHIEF FINANCIAL OFFICER",
        "authorized_official_telephone_number": "321-543-3903"
    },
    "taxonomies": [
        {
            "code": "310400000X",
            "taxonomy_group": "",
            "desc": "Assisted Living Facility",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Scott Luthy, PHARMD
• Barlow St Clair Lynch, MD
• Jane Clemons Lyons, LCSW
• Magnolia Court Assisted Living
• Magnolia House
• Misty Faith Marot, M.A., B.C.B.A.
• Martha Fay LCSW Beachside Mental Health Counseling Services LLC
• Nazish Masoodi, MD
• McCormick Organization, Inc
• Michael McGoohan, DO

• Assisted Living Facility in Cocoa Beach, FL
• Providers in Cocoa Beach, FL by specialty
• Assisted Living Facility in Florida

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 20, 2015; 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.