MAGNOLIA SUPPORT CENTER LLC
NPI 1033905476
Clinic/Center - Rehabilitation in Lakewood, CA

Q: What is the provider's specialty?

The provider's specialty is Clinic/Center with taxonomy code 261QR0400X and a focus in Rehabilitation.

Active since April 15, 2025

4115 SOUTH ST, LAKEWOOD, CA 90712(562) 780-6532(310) 438-2105 Get Directions Write a Review

NPPES record last updated: June 22, 2026. Verified against the NPPES registry weekly; last sync: July 19, 2026.

Record update history: Jan 26, 2026, Jan 23, 2026, Jul 12, 2025 and 1 more (4 updates tracked since 2025).

Table of Contents

NPI Profile Information
Primary Taxonomy
Authorized Official
Other Providers Same Location
Frequently Asked Questions

Organization
Clinic/Center
Rehabilitation

About MAGNOLIA SUPPORT CENTER LLC

This page provides the complete NPI Profile along with additional information for Magnolia Support Center Llc, a provider established in Lakewood, California operating as a Clinic/center, focusing in rehabilitation . The healthcare provider is registered in the NPI registry with number 1033905476 assigned on April 2025. The practitioner's primary taxonomy code is 261QR0400X. The provider is registered as an organization and their NPI record was last updated June 2026. The authorized official of this NPI record is Mrs. Rocio Mallari (Ceo)

NPI: 1033905476 Verify this NPI
Provider Name: MAGNOLIA SUPPORT CENTER LLC
Other Name Type: (6)
Entity Type: Organization
Location Address: 4115 SOUTH ST LAKEWOOD, CA 90712
Location Phone: (562) 780-6532
Location Fax: (310) 438-2105
Mailing Address: 16958 SIERRA VISTA WAY CERRITOS, CA 90703
Mailing Phone: (562) 774-5732
Is Sole Proprietor?: No
Is Organization Subpart?: No
Enumeration Date: 04-15-2025
Last Update Date: 06-22-2026
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Specialty - Primary Taxonomy

The NPI enumerator requires providers to submit at least one taxonomy code. A taxonomy code is a unique 10-character code that describes the healthcare provider type, classification, and the area of specialization. There could be only one primary taxonomy code per NPI record. For individual NPIs the license data is associated to the taxonomy code.

Classification: Clinic/Center Rehabilitation
Taxonomy Code: 261QR0400X
Type: Ambulatory Health Care Facilities

Authorized Official

The authorized official is the designated individual with the legal authority to make changes to the provider’s official NPI record. For organizations, the authorized official must be a general partner, chairman of the board, CEO, CFO or a direct owner holding at least a 5 percent stake in the medical organization.

Authorized Official Name: MRS. ROCIO MALLARI
Authorized Official Title: CEO
Authorized Official Phone: (562) 774-5732