Provider Demographics
NPI:1760081301
Name:MAGNOLIA HEALTHCARE SOLUTIONS, LLC
Entity Type:Organization
Organization Name:MAGNOLIA HEALTHCARE SOLUTIONS, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:AKELIA GRAISE, RN;
Authorized Official - Prefix:MS
Authorized Official - First Name:AKELIA
Authorized Official - Middle Name:
Authorized Official - Last Name:GRAISE
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:769-229-5907
Mailing Address - Street 1:402 GREENFIELD RIDGE CIR
Mailing Address - Street 2:
Mailing Address - City:BRANDON
Mailing Address - State:MS
Mailing Address - Zip Code:39042-7025
Mailing Address - Country:US
Mailing Address - Phone:769-229-5907
Mailing Address - Fax:
Practice Address - Street 1:402 GREENFIELD RIDGE CIR
Practice Address - Street 2:
Practice Address - City:BRANDON
Practice Address - State:MS
Practice Address - Zip Code:39042-7025
Practice Address - Country:US
Practice Address - Phone:769-229-5907
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2020-10-24
Last Update Date:2020-10-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251J00000XAgenciesNursing Care