Memory Lane, Inc.

LBN: Memory Lane, Inc.
Memory Lane, Inc. is an health care organization with primary practice located at 1012 Fayetteville Rd , Van Buren AR 72956-3471. The organization recently has 2 registered licenses in different health care specialties including Nursing & Custodial Care Facilities / Assisted Living Facility, Nursing & Custodial Care Facilities / Alzheimer Center (Dementia Center). Nursing & Custodial Care Facilities / Assisted Living Facility is the primary health care specialty. Memory Lane, Inc. can be contacted via phone (479) 474-7223, or through Johnson, Debra Jean via phone (479) 474-7223.

Contact Information

Primary practice address
1012 Fayetteville Rd Van Buren AR 72956-3471
Phone: (479) 474-7223
Fax: (479) 474-3444
Website:
Map and Directions
Authorized official contact:
Name: Johnson, Debra Jean
Phone: (479) 474-7223

Health care specialties

SpecialtyCodeLicense #State
Nursing & Custodial Care Facilities / Assisted Living Facility 310400000X 101 Arkansas
Nursing & Custodial Care Facilities / Alzheimer Center (Dementia Center) 311500000X 101 Arkansas

Profile Details

NPI number 1598149411
LBN Legal business name Memory Lane, Inc.
DBA Doing business as
Authorized official Johnson, Debra Jean
Entity Organization
Organization subpart 1 No
Enumeration date Jul 10th, 2015
Last updated Jul 10th, 2015 - about 11 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.

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Identifiers

StateTypeNumberIssuer
All States NPI 1598149411 NPPES
Arkansas Other 101 ASSISTED LIVING LEVEL II

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