MAGNOLIA HAVEN NURSING HOME, LLC (NPI# 1831429158) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1831429158 |
| Entity Type | Organization |
| Organization Name | MAGNOLIA HAVEN NURSING HOME, LLC |
| Other Organization Name | TUSKEGEE REHABILITATION CLINIC |
| Practice Address |
602 Auburn St Tuskegee AL 36083-7274 |
| Practice Telephone | 3347274960 |
| Mailing Telephone | 3347274960 |
| Enumeration Date | 2010-01-08 |
| Last Update Date | 2010-07-27 |
| Authorized Official Name | OIDA GANDY (ADMINISTRATOR) |
| Authorized Official Telephone | 3347274960 |
| Is Organization Subpart | Y |
| Parent Organization Name | MAGNOLIA HAVEN NURSING HOME, LLC |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 261QR0401X |
Clinic/Center Specialization: Rehabilitation, Comprehensive Outpatient Rehabilitation Facility (CORF) |
R4401 | AL | Ambulatory Health Care Facilities |
| Other Name | Type Code |
|---|---|
| Tuskegee Rehabilitation Clinic | Doing Business As Name - Organization |
| Entity Type | Entity Name | Entity Address |
|---|---|---|
| System for Award Management (SAM) Entities | MAGNOLIA HAVEN NURSING HOME, LLC | 603 Wright St, Tuskegee, AL 36083-1585 |
| Street Address |
602 AUBURN ST |
| City | TUSKEGEE |
| State | AL |
| Zip Code | 36083-7274 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1972698587 | Nguyet H Smith | Pharmacist | Central Alabama Veterans Health Care System, Pharmacy, 2400 Hospital Road, Tuskegee, AL 36083 | 2006-10-03 |
| 1619908795 | Carmen Elizabeth Beverly | Podiatrist | Cavhcs 2400 Hospital Rd, Dm Clinic, Tuskegee, AL 36083 | 2006-07-06 |
| 1275564635 | Tim Landers | Audiologist | 2400 Hospital Rd., Cavhcs - 126, Tuskegee, AL 36083 | 2006-07-05 |
| 1790726867 | Lasan Davis | Family Medicine | 203 West Lee Street, Tuskegee, AL 36083 | 2006-06-09 |
| 1831144344 | Denise Free Lensgraf-landers | Audiologist | Cavhcs Audiology (117), 2400 Hospital Road, Tuskegee, AL 36083 | 2006-05-23 |
| 1396705836 | Mark Patrick Mcguire | Optometrist | 2400 Hosptial Road, Eye Clinic Cavhcs, Tuskegee, AL 36083 | 2006-03-27 |
| 1164402863 | Lisa R Green | Optometrist | 2400 Hospital Rd Bldg 3, Tuskegee, AL 36083 | 2006-01-19 |
| 1265775936 | Shari Smith | Social Worker | 2400 Hospital Rd., Cavhcs- Social Work Services, Tuskegee, AL 36083 | 2013-04-01 |
| 1689902710 | Penny M Genous | Social Worker | 2400 Hospital Rd, Tuskegee, AL 36083 | 2009-12-01 |
| 1194954255 | Kevin Mcbeth Johnson | Student in an Organized Health Care Education/Training Program | 2400 Hospital Rd, Tuskegee, AL 36083 | 2009-07-10 |
| Find all providers in zip 36083 | ||||
| Taxonomy Code | 261QR0401X |
| Grouping | Ambulatory Health Care Facilities |
| Classification | Clinic/Center |
| Specialization | Rehabilitation, Comprehensive Outpatient Rehabilitation Facility (CORF) |
| Definition to come... |
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| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.