| NPI | 1043902810 |
|---|---|
| Doing Business As | MAGNOLIA VILLAGE OF FORT WAYNE |
| Entity Type | Organization |
| Authorized Contact | VADIM MUCHNIK President 847-602-8050 |
| Organization Subpart ? | No |
| Primary Taxonomy | 310400000X Assisted Living Facility |
| Enumeration Date | 2023-05-22 |
| Last Update Date | 2023-05-22 |