Magnolia Manor LLC

Primary specialty

Assisted Living FacilityTaxonomy code 310400000X

Legal business name

MAGNOLIA MANOR LLC

Practice address

14221 N 136TH LN
Surprise, AZ 85379-8453

Phone

(602) 348-1789

Fax

(623) 292-5977

NPI assigned

Sep 24, 2024

Last updated

Sep 24, 2024By the provider in NPPES

Organization subpart

No

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

Authorized official

Name

Ana Ciutac

Title

Managing Employee

Phone

(602) 348-1789

Specialties & licenses 1

Addresses

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

{
    "created_epoch": "1727136000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1727136000000",
    "number": "1871310425",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "14221 N 136TH LN",
            "city": "SURPRISE",
            "state": "AZ",
            "postal_code": "853798453",
            "telephone_number": "602-348-1789",
            "fax_number": "623-292-5977"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "14221 N 136TH LN",
            "city": "SURPRISE",
            "state": "AZ",
            "postal_code": "853798453",
            "telephone_number": "602-348-1789",
            "fax_number": "623-292-5977"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "MAGNOLIA MANOR LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2024-09-24",
        "last_updated": "2024-09-24",
        "certification_date": "2024-09-24",
        "status": "A",
        "authorized_official_last_name": "CIUTAC",
        "authorized_official_first_name": "ANA",
        "authorized_official_title_or_position": "MANAGING EMPLOYEE",
        "authorized_official_telephone_number": "602-348-1789"
    },
    "taxonomies": [
        {
            "code": "310400000X",
            "taxonomy_group": "",
            "desc": "Assisted Living Facility",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• Assisted Living Facility in Surprise, AZ
• Providers in Surprise, AZ by specialty
• Assisted Living Facility in Arizona

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 24, 2024; 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.