Memory Lane Assisted Living, LLC

Primary specialty

Assisted Living FacilityTaxonomy code 310400000X

Legal business name

MEMORY LANE ASSISTED LIVING, LLC

Practice address

32802 Wright Rd
Magnolia, TX 77355-8456

Phone

(281) 259-9657

Fax

(281) 259-2936

NPI assigned

May 25, 2017

Last updated

Jul 21, 2022By the provider in NPPES

Organization subpart

No

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name

Ada Fiscu, RN

Title

DSN/ Administrator

Phone

(832) 627-6918

Specialties & licenses 1

Addresses

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1495670400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1658361600000",
    "number": "1063940732",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "32802 WRIGHT RD",
            "city": "MAGNOLIA",
            "state": "TX",
            "postal_code": "773558456",
            "telephone_number": "281-259-9657",
            "fax_number": "281-259-2936"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "32802 WRIGHT RD",
            "city": "MAGNOLIA",
            "state": "TX",
            "postal_code": "773558456",
            "telephone_number": "281-259-9657",
            "fax_number": "281-259-2936"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "32802 Wright Rd",
            "address_purpose": "LOCATION",
            "city": "Magnolia",
            "state": "TX",
            "postal_code": "773558456",
            "country_code": "US",
            "telephone_number": "281-259-9657",
            "fax_number": "281-259-2936",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "organization_name": "MEMORY LANE ASSISTED LIVING, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2017-05-25",
        "last_updated": "2022-07-21",
        "status": "A",
        "authorized_official_last_name": "FISCU",
        "authorized_official_first_name": "ADA",
        "authorized_official_title_or_position": "DSN/ ADMINISTRATOR",
        "authorized_official_telephone_number": "832-627-6918",
        "authorized_official_credential": "RN"
    },
    "taxonomies": [
        {
            "code": "310400000X",
            "taxonomy_group": "",
            "desc": "Assisted Living Facility",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 21, 2022; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.