Memory Mission LLC

Primary specialty

Assisted Living FacilityTaxonomy code 310400000X

Legal business name

MEMORY MISSION LLC

Doing business as

Stone Lodge Memory Care

Practice address

415 N Chippewa St
Shepherd, MI 48883-9033

Phone

(989) 828-5683

Fax

(989) 567-2161

NPI assigned

Jan 2, 2025

Last updated

Jan 2, 2025By 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

Mr. Kazem Hodroge

Title

Owner

Phone

(989) 828-5683

Specialties & licenses 1

Addresses

Other names 1

• Stone Lodge Memory Care Doing business as

These CMS records do not include an NPI. They are shown because their name and street address match this provider’s.

CLIA laboratory certificates

Locations

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

{
    "created_epoch": "1735776000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1735776000000",
    "number": "1144039330",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "415 N CHIPPEWA ST",
            "city": "SHEPHERD",
            "state": "MI",
            "postal_code": "488839033",
            "telephone_number": "989-828-5683",
            "fax_number": "989-567-2161"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "415 N CHIPPEWA ST",
            "city": "SHEPHERD",
            "state": "MI",
            "postal_code": "488839033",
            "telephone_number": "989-828-5683",
            "fax_number": "989-567-2161"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "MEMORY MISSION LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2025-01-02",
        "last_updated": "2025-01-02",
        "certification_date": "2025-01-02",
        "status": "A",
        "authorized_official_last_name": "HODROGE",
        "authorized_official_first_name": "KAZEM",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "989-828-5683",
        "authorized_official_name_prefix": "Mr."
    },
    "taxonomies": [
        {
            "code": "310400000X",
            "taxonomy_group": "",
            "desc": "Assisted Living Facility",
            "state": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Stone Lodge Memory Care",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

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• Assisted Living Facility in Shepherd, MI
• Providers in Shepherd, MI by specialty
• Assisted Living Facility in Michigan

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 2, 2025; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.