Provider Demographics
NPI:1902670078
Name:MAGNOLIA HOME CARE
Entity Type:Organization
Organization Name:MAGNOLIA HOME CARE
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER/CEO
Authorized Official - Prefix:MRS
Authorized Official - First Name:HAESOOK
Authorized Official - Middle Name:
Authorized Official - Last Name:HONG
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:267-968-5984
Mailing Address - Street 1:103 STEVERS MILL RD
Mailing Address - Street 2:
Mailing Address - City:NORTH WALES
Mailing Address - State:PA
Mailing Address - Zip Code:19454-1240
Mailing Address - Country:US
Mailing Address - Phone:267-968-5984
Mailing Address - Fax:
Practice Address - Street 1:103 STEVERS MILL RD
Practice Address - Street 2:
Practice Address - City:NORTH WALES
Practice Address - State:PA
Practice Address - Zip Code:19454-1240
Practice Address - Country:US
Practice Address - Phone:267-968-5984
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2023-11-09
Last Update Date:2023-11-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes253Z00000XAgenciesIn Home Supportive Care