Provider Demographics
NPI:1497642391
Name:SWEET MAGNOLIA SENIOR CARE LLC
Entity type:Organization
Organization Name:SWEET MAGNOLIA SENIOR CARE LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER, PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:MONICA
Authorized Official - Middle Name:
Authorized Official - Last Name:JORDAN
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:601-480-4987
Mailing Address - Street 1:127 COUNTY ROAD 52830
Mailing Address - Street 2:
Mailing Address - City:HEIDELBERG
Mailing Address - State:MS
Mailing Address - Zip Code:39439-3520
Mailing Address - Country:US
Mailing Address - Phone:601-480-4987
Mailing Address - Fax:
Practice Address - Street 1:127 COUNTY ROAD 52830
Practice Address - Street 2:
Practice Address - City:HEIDELBERG
Practice Address - State:MS
Practice Address - Zip Code:39439-3520
Practice Address - Country:US
Practice Address - Phone:601-480-4987
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2025-06-23
Last Update Date:2025-06-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes253Z00000XAgenciesIn Home Supportive Care