| NPI | 1003423120 |
|---|---|
| Doing Business As | MAGNOLIA PROVIDER SERVICES |
| Entity Type | Organization |
| Authorized Contact | MICHELLE CANTINA AUSBERRY President 832-342-6679 |
| Organization Subpart ? | Yes |
| Primary Taxonomy | 251C00000X Day Training, Developmentally Disabled Services |
| Enumeration Date | 2020-09-24 |
| Last Update Date | 2020-12-16 |