Memory Lane Assisted Living, LLC

NPI #1063940732 in Magnolia, Texas

Provider Information

NPI Number: 1063940732
Entity Type: Organization
Organization Name: Memory Lane Assisted Living, LLC
Primary Specialty: Assisted Living Facility
Enumeration Date: May 25, 2017
Last Updated: Jul 21, 2022

Practice Location

Address: 32802 WRIGHT RD
City: Magnolia
State: Texas
ZIP Code: 77355-8456
Phone: (281) 259-9657

Authorized Official

Name: ADA FISCU, RN
Title: DSN/ ADMINISTRATOR
Phone: (832) 627-6918

Specialties & Taxonomy Codes

Specialty	Taxonomy Code	Primary
Assisted Living Facility	310400000X	Primary

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