Provider Demographics
NPI:1316063266
Name:MAGNA HEALTH CARE INC
Entity type:Organization
Organization Name:MAGNA HEALTH CARE INC
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT/CEO
Authorized Official - Prefix:MR
Authorized Official - First Name:LEONARD
Authorized Official - Middle Name:
Authorized Official - Last Name:AGBASI
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:918-459-5074
Mailing Address - Street 1:4271 W ALBANY ST
Mailing Address - Street 2:
Mailing Address - City:BROKEN ARROW
Mailing Address - State:OK
Mailing Address - Zip Code:74012-1233
Mailing Address - Country:US
Mailing Address - Phone:918-459-5074
Mailing Address - Fax:918-459-5075
Practice Address - Street 1:4271 W ALBANY ST
Practice Address - Street 2:
Practice Address - City:BROKEN ARROW
Practice Address - State:OK
Practice Address - Zip Code:74012-1233
Practice Address - Country:US
Practice Address - Phone:918-459-5074
Practice Address - Fax:918-459-5075
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-03-22
Last Update Date:2023-03-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251C00000XAgenciesDay Training, Developmentally Disabled Services
No251B00000XAgenciesCase Management
No251J00000XAgenciesNursing Care
No253Z00000XAgenciesIn Home Supportive Care
Provider Identifiers
StateIdentifier IDID TypeIssuer
OK100634480HMedicaid
OK100634480MMedicaid
OK100634480KMedicaid
OK100634480CMedicaid
OK100634480JMedicaid
OK100634480LMedicaid