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MAGNOLA MANOR AT DAYTONA BEACH, LLC
NPI 1134675234
Assisted Living Facility in Daytona Beach, FL

Active since August 29, 2016
252 FOREST LAKE BLVD, DAYTONA BEACH, FL 32119(863) 226-0358 Get Directions Write a Review

NPPES record last updated: February 16, 2022. Verified against the NPPES registry weekly; last sync: July 19, 2026.

Record update history: Feb 16, 2022, Jan 26, 2022, Aug 29, 2016 (3 updates tracked since 2016).

Table of Contents

  1. NPI Profile Information
  2. Primary Taxonomy
  3. Authorized Official
  4. Other Providers Same Location
  5. Frequently Asked Questions
  • Organization
  • Assisted Living Facility

About MAGNOLA MANOR AT DAYTONA BEACH, LLC

This page provides the complete NPI Profile along with additional information for Magnola Manor At Daytona Beach, Llc, a provider established in Daytona Beach, Florida operating as a Assisted Living Facility. The healthcare provider is registered in the NPI registry with number 1134675234 assigned on August 2016. The practitioner's primary taxonomy code is 310400000X with license number AL8869 (FL). The provider is registered as an organization and their NPI record was last updated 4 years ago. The authorized official of this NPI record is Savitri Johnson (Administrative Assistant)

NPI
1134675234 Verify this NPI
Provider Name
MAGNOLA MANOR AT DAYTONA BEACH, LLC
Entity Type
Organization
Location Address
252 FOREST LAKE BLVD DAYTONA BEACH, FL 32119
Location Phone
(863) 226-0358
Mailing Address
59 LAKE MORTON DR LAKELAND, FL 33801
Is Sole Proprietor?
No
Is Organization Subpart?
No
Enumeration Date
08-29-2016
Last Update Date
02-16-2022
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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

Assisted Living Facility

Taxonomy Code
310400000X
Type
Nursing & Custodial Care Facilities
License No.
AL8869
License State
FL
Taxonomy Description
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.

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

SAVITRI JOHNSON

Authorized Official Title
ADMINISTRATIVE ASSISTANT
Authorized Official Phone
(863) 226-0358

Reviews for MAGNOLA MANOR AT DAYTONA BEACH, LLC

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Other Providers at the Same Location


The following 2 providers are registered at the same or a nearby location.

SELAH - FOREST LAKE MANOR, LLC
Assisted Living Facility
252 FOREST LAKE BLVD
DAYTONA BEACH, FL 32119
Volusia County (386) 760-7174
VERITAS INCARE, LLC
Assisted Living Facility
252 FOREST LAKE BLVD
DAYTONA BEACH, FL 32119
Volusia County (386) 760-7174

Frequently Asked Questions

What is MAGNOLA MANOR AT DAYTONA BEACH, LLC's NPI number?

The NPI number assigned to this healthcare provider is 1134675234, enumerated as an "organization" on August 29, 2016.

Where is the provider located?

The provider is located at 252 FOREST LAKE BLVD DAYTONA BEACH, FL 32119 and the phone number is (863) 226-0358.

What is the provider's specialty?

Assisted Living Facility with taxonomy code 310400000X.