| NPI | 1366101289 |
|---|---|
| Doing Business As | MAGNOLIA RECOVERY |
| Entity Type | Organization |
| Authorized Contact | GREGORY MIKITARIAN Principal 818-796-4311 |
| Organization Subpart ? | No |
| Primary Taxonomy | 324500000X Substance Abuse Rehabilitation Facility |
| Enumeration Date | 2021-12-08 |
| Last Update Date | 2022-05-18 |