| NPI | 1649820341 |
|---|---|
| Doing Business As | MEMORY LANE CARE HOME |
| Entity Type | Organization |
| Authorized Contact | HANNAH FAYE ANDERSON Nurse Administrator 435-720-7295 |
| Organization Subpart ? | No |
| Primary Taxonomy | 313M00000X Nursing Facility/Intermediate Care Facility |
| Additional Taxonomies | 251C00000X Day Training, Developmentally Disabled Services |
| 251J00000X Nursing Care | |
| 273Y00000X Rehabilitation Unit | |
| 314000000X Skilled Nursing Facility | |
| 385H00000X Respite Care | |
| Enumeration Date | 2019-09-13 |
| Last Update Date | 2019-09-13 |