Magnolia Manor
LBN: Cresthaven Health Care Center Ltd Co
Magnolia Manor is an health care organization with primary practice located at 4400 Gulf Ave , Groves TX 77619-3717. The organization recently has 2 registered licenses in different health care specialties including Nursing & Custodial Care Facilities / Skilled Nursing Facility, Suppliers / Parenteral & Enteral Nutrition. Nursing & Custodial Care Facilities / Skilled Nursing Facility is the primary health care specialty.
Cresthaven Health Care Center Ltd Co can be contacted via phone (409) 962-5785, or through Underhill, Robin via phone (214) 954-4114.
Contact Information
Primary practice address
4400 Gulf Ave
Groves TX 77619-3717
Phone: (409) 962-5785
Fax: (409) 962-2944
Website:
Health care specialties
| Specialty | Code | License # | State |
|---|---|---|---|
| Nursing & Custodial Care Facilities / Skilled Nursing Facility | 314000000X | 114561 | Texas |
| Suppliers / Parenteral & Enteral Nutrition | 332BP3500X |
Profile Details
| NPI number | 1164418554 |
|---|---|
| LBN Legal business name | Cresthaven Health Care Center Ltd Co |
| DBA Doing business as | Magnolia Manor |
| Authorized official | Underhill, Robin |
| Entity | Organization |
| Organization subpart 1 | No |
| Enumeration date | Sep 21st, 2005 |
| Last updated | Sep 16th, 2008 - about 17 years ago |
1 Some organizations, which are providing health care services, may consist of units or departments that provide different types of health care services or have several separate physical locations, where health care service is provided. These units, departments or physical locations are not themselves legal entities. However, each of them is part of the organization, which is a legal entity. The organization may decide whether its subparts, if it has any, should have their own NPI numbers. In case a subpart conducts any HIPAA standard transactions by itself, without its parent's involvement, it must have its own NPI number.
Identifiers
| State | Type | Number | Issuer |
|---|---|---|---|
| All States | NPI | 1164418554 | NPPES |
| Texas | MEDICAID | 022622701 | |
| Texas | MEDICAID | 000446604 | |
| Texas | MEDICAID | 021439701 |
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