Memory Lane Of Dexter

LBN: Memory Lane Of Dexter, Llc
Memory Lane Of Dexter is an health care organization with primary practice located at 415 S Catalpa St , Dexter MO 63841-2017. The organization recently has only one registered license in Nursing & Custodial Care Facilities / Skilled Nursing Facility, which is considered as the primary health care specialty. Memory Lane Of Dexter, Llc can be contacted via phone (573) 624-7491, or through Sells, Benjamin P via phone (573) 614-7472.

Contact Information

Primary practice address
415 S Catalpa St Dexter MO 63841-2017
Phone: (573) 624-7491
Fax: (573) 624-2061
Website:
Map and Directions
Authorized official contact:
Name: Sells, Benjamin P
Phone: (573) 614-7472

Health care specialties

SpecialtyCodeLicense #State
Nursing & Custodial Care Facilities / Skilled Nursing Facility 314000000X

Profile Details

NPI number 1366997678
LBN Legal business name Memory Lane Of Dexter, Llc
DBA Doing business as Memory Lane Of Dexter
Authorized official Sells, Benjamin P
Entity Organization
Organization subpart 1 No
Enumeration date Aug 17th, 2016
Last updated Apr 13th, 2023 - about 2 years ago

1 Some organizations, which are providing health care services, may consist of units or departments that provide different types of health care services or have several separate physical locations, where health care service is provided. These units, departments or physical locations are not themselves legal entities. However, each of them is part of the organization, which is a legal entity. The organization may decide whether its subparts, if it has any, should have their own NPI numbers. In case a subpart conducts any HIPAA standard transactions by itself, without its parent's involvement, it must have its own NPI number.

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Identifiers

StateTypeNumberIssuer
All States NPI 1366997678 NPPES
Missouri MEDICAID 101456309

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