| NPI | 1740664887 |
|---|---|
| Doing Business As | MEMORY LANE COTTAGE |
| Entity Type | Organization |
| Authorized Contact | KELLY JEAN IRISH Administrator 813-632-1270 |
| Organization Subpart ? | No |
| Primary Taxonomy | 310400000X Assisted Living Facility |
| Enumeration Date | 2015-07-18 |
| Last Update Date | 2023-09-12 |