MAGNOLIS GARDENS INC NPI 1053448522

NPI Information

  • NPI: 1053448522
  • Provider Name: MAGNOLIS GARDENS, INC
  • Classification: Assisted Living Facility - 310400000X
  • Entity Type: Organization
  • Doing Business As: MAGNOLIA GARDENS SENIOR CARE
  • Address: 829 ROANOKE AVE
    ROANOKE RAPIDS, NC
    ZIP 27870
  • Phone: (252) 308-1743

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NPI Details

MAGNOLIS GARDENS, INC is an assisted living facility in Roanoke Rapids, NC. The provider is a facility providing supportive services to individuals who can function independently in most areas of activity, but need assistance and/or monitoring to assure safety and well being. MAGNOLIS GARDENS, INC NPI is 1053448522. The provider is registered as an organization entity type.
The provider Is Doing Business As Magnolia Gardens Senior Care.

The provider's business location address is:

829 ROANOKE AVE
ROANOKE RAPIDS, NC
ZIP 27870-717
Phone: (252) 308-1743

The provider's authorized official is Kim Simpson .
The authorized official title is Ceo and has the following contact phone number (252) 535-5006.

The enumeration date for this NPI number is 2/28/2007 and was last updated on 8/22/2020.

Taxonomy Codes

The NPI record includes the healthcare provider taxonomy classification, state license number and state of licensure. The following information regarding the scope of practice of this provider is available:

No. Taxonomy Code Taxonomy Clasification Taxonomy Specialization License Number License State Primary
1310400000XAssisted Living FacilityFCL-042-002NORTH CAROLINAYes

Other Identifiers

The following information regarding additional identifiers associated to this NPI record includes the other identifier number, identifier type, identifier state and issuer.

No. Other Provider Identifier Other Provider Identifier Type Other Provider Identifier State Other Provider Identifier Issuer
17802782MEDICAIDNORTH CAROLINA

What is NPI?

NPI stands for National Provider Identifier. The NPI is a 10-digit identification number that is completely unique. The NPI number by itself does not contain any identifiable information such as a provider’s speciality or location. The NPI is assigned to individuals or organizacions for their lifespan and it is independent of key provider information type updates like a change of practices, location or speciality.

This page was last updated on: 11/21/2025

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