| NPI | 1407401979 |
|---|---|
| Former Legal Business Name | MAGNOLIA ANGELS LLC |
| Entity Type | Organization |
| Authorized Contact | MYKESHIA TAYLOR Administrator 317-995-7282 |
| Organization Subpart ? | No |
| Primary Taxonomy | 251E00000X Home Health |
| Enumeration Date | 2019-08-01 |
| Last Update Date | 2019-08-01 |