Provider Demographics
NPI:1376207910
Name:MAGICAL MOMENTS SENIOR CARE
Entity Type:Organization
Organization Name:MAGICAL MOMENTS SENIOR CARE
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:BUSINESS OWNER
Authorized Official - Prefix:MS
Authorized Official - First Name:CLAUDIA
Authorized Official - Middle Name:NESHELL
Authorized Official - Last Name:NELSON
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:205-354-4298
Mailing Address - Street 1:820 SPRINGVILLE DR
Mailing Address - Street 2:
Mailing Address - City:BIRMINGHAM
Mailing Address - State:AL
Mailing Address - Zip Code:35215-6817
Mailing Address - Country:US
Mailing Address - Phone:205-354-4298
Mailing Address - Fax:
Practice Address - Street 1:1 CHASE CORPORATE DR
Practice Address - Street 2:
Practice Address - City:HOOVER
Practice Address - State:AL
Practice Address - Zip Code:35244-1026
Practice Address - Country:US
Practice Address - Phone:205-354-4298
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2021-10-29
Last Update Date:2021-10-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes253Z00000XAgenciesIn Home Supportive Care