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MEMORY LANE COTTAGE AT TAMPA PALMS LLC NPI 1740664887


NPI Information

NPI: 1740664887
Provider Name: MEMORY LANE COTTAGE AT TAMPA PALMS, LLC

Doing Business As: MEMORY LANE COTTAGE

Classification: Assisted Living Facility - 310400000X
Entity Type: Organization

CLIA Number: 10D2204817

Address:
5175 CYPRESS PRESERVE DR
TAMPA, FL
ZIP 33647
Phone: (813) 632-1270
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MEMORY LANE COTTAGE AT TAMPA PALMS, LLC is an assisted living facility in Tampa, FL. The provider is a facility providing supportive services to individuals who can function independently in most areas of activity, but need assistance and/or monitoring to assure safety and well being. MEMORY LANE COTTAGE AT TAMPA PALMS, LLC NPI is 1740664887. The provider is registered as an organization entity type.
The provider Is Doing Business As Memory Lane Cottage.

The provider's business location address is:

5175 CYPRESS PRESERVE DR
TAMPA, FL
ZIP 33647-674
Phone: (813) 632-1270
Fax: (813) 632-1272

The provider's authorized official is Kelly Jean Irish .
The authorized official title is Administrator and has the following contact phone number (813) 632-1270.

The CLIA number assigned to this NPI record is 10D2204817 - assisted living facility with a certificate type of Certificate of Waiver.

The enumeration date for this NPI number is 7/18/2015 and was last updated on 9/12/2023.


Taxonomy Codes

The NPI record includes the healthcare provider taxonomy classification, state license number and state of licensure. The following information regarding the scope of practice of this provider is available:

No.Taxonomy CodeTaxonomy ClasificationTaxonomy SpecializationLicense NumberLicense StatePrimary
1310400000XAssisted Living FacilityYes

What is NPI?

NPI stands for National Provider Identifier. The NPI is a 10-digit identification number that is completely unique. The NPI number by itself does not contain any identifiable information such as a provider’s speciality or location. The NPI is assigned to individuals or organizacions for their lifespan and it is independent of key provider information type updates like a change of practices, location or speciality.

This page was last updated on: 4/28/2024

All materials and services on this site are provided on an "as is" and "as available" basis without warranty of any kind. The NPI record is maintained by the National Plan & Provider Enumeration System (NPPES) and anyone may request this information and other NPPES health care provider data from HHS under The Freedom of Information Act (FOIA), Title 5 of the United States Code, section 552. To update the NPI records please contact the NPPES.