| 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 | 2025-09-02 |