Memory Lane Adult Day Care of Granbury LLC

Primary specialty

Adult Day Care Clinic/CenterTaxonomy code 261QA0600X

Legal business name

MEMORY LANE ADULT DAY CARE OF GRANBURY LLC

Practice address

1333 N Plaza Dr
Granbury, TX 76048-2559

Phone

(337) 592-3854

NPI assigned

Jun 8, 2021

Organization subpart

No

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

Authorized official

Name

Eugenia Washington

Title

Ceo

Phone

(337) 592-3854

Specialties & licenses 1

Addresses

Other names 1

• Memory Lane Adult Day Care of Granbury Former legal business name

Locations

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

{
    "created_epoch": "1623110400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1629676800000",
    "number": "1871160754",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1333 N PLAZA DR",
            "city": "GRANBURY",
            "state": "TX",
            "postal_code": "760482559",
            "telephone_number": "337-592-3854"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1333 N PLAZA DR",
            "city": "GRANBURY",
            "state": "TX",
            "postal_code": "760482559",
            "telephone_number": "337-592-3854"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "MEMORY LANE ADULT DAY CARE OF GRANBURY LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2021-06-08",
        "last_updated": "2021-08-23",
        "certification_date": "2021-08-20",
        "status": "A",
        "authorized_official_last_name": "WASHINGTON",
        "authorized_official_first_name": "EUGENIA",
        "authorized_official_title_or_position": "CEO",
        "authorized_official_telephone_number": "337-592-3854"
    },
    "taxonomies": [
        {
            "code": "261QA0600X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Adult Day Care",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Memory Lane Adult Day Care of Granbury",
            "code": "4",
            "type": "Former Legal Business Name"
        },
        {
            "organization_name": "Memory Lane Adult Day Care of Granbury",
            "code": "4",
            "type": "Former Legal Business Name"
        }
    ]
}

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• Adult Day Care Clinic/Center in Granbury, TX
• Providers in Granbury, TX by specialty
• Adult Day Care Clinic/Center in Texas

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 23, 2021; 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.