Provider Demographics
NPI:1184832743
Name:COURTYARDS OF MAGNOLIA, LLC
Entity Type:Organization
Organization Name:COURTYARDS OF MAGNOLIA, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:MANAGING MEMBER
Authorized Official - Prefix:
Authorized Official - First Name:JAMES
Authorized Official - Middle Name:E
Authorized Official - Last Name:HOLT
Authorized Official - Suffix:SR
Authorized Official - Credentials:
Authorized Official - Phone:252-633-1143
Mailing Address - Street 1:PO BOX 1189
Mailing Address - Street 2:
Mailing Address - City:NEW BERN
Mailing Address - State:NC
Mailing Address - Zip Code:28563-1189
Mailing Address - Country:US
Mailing Address - Phone:252-633-1143
Mailing Address - Fax:
Practice Address - Street 1:3407 OAKS RD
Practice Address - Street 2:
Practice Address - City:NEW BERN
Practice Address - State:NC
Practice Address - Zip Code:28560-2718
Practice Address - Country:US
Practice Address - Phone:252-633-1143
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-05-18
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes310400000XNursing & Custodial Care FacilitiesAssisted Living Facility