Magnolia House Pch, INC

NPI #1053519579 in Douglas, Georgia

Provider Information

NPI Number: 1053519579
Entity Type: Organization
Organization Name: Magnolia House Pch, INC
Primary Specialty: Residential Treatment Facility, Intellectual and/or Developmental Disabilities
Enumeration Date: Jul 5, 2007
Last Updated: Aug 22, 2020

Practice Location

Address: 221 COLLEGE AVE S
City: Douglas
State: Georgia
ZIP Code: 31533-2303
Phone: (912) 384-3377

Authorized Official

Name: MS. MELISSA R WHITLEY, RN
Title: DIRECTOR
Phone: (912) 384-3377

Specialties & Taxonomy Codes

Specialty	Taxonomy Code	Primary
Residential Treatment Facility, Intellectual and/or Developmental Disabilities	320600000X	Primary

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