| NPI | 1518397249 |
|---|---|
| Doing Business As | MAGNOLIA HOUSE ASSISTED LIVING |
| Entity Type | Organization |
| Authorized Contact | GAVIN FOTHERGILL Owner 801-230-4956 |
| Organization Subpart ? | No |
| Primary Taxonomy | 385H00000X Respite Care |
| Enumeration Date | 2013-11-15 |
| Last Update Date | 2013-11-15 |