Provider Demographics
NPI:1417637315
Name:LIVING MEMORIES ASSISTED LIVING FACILITY
Entity Type:Organization
Organization Name:LIVING MEMORIES ASSISTED LIVING FACILITY
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:CHRISTIAN
Authorized Official - Middle Name:
Authorized Official - Last Name:ONYEMEM
Authorized Official - Suffix:
Authorized Official - Credentials:CPA
Authorized Official - Phone:346-754-3490
Mailing Address - Street 1:3415 MARLENE MEADOW WAY
Mailing Address - Street 2:
Mailing Address - City:RICHMOND
Mailing Address - State:TX
Mailing Address - Zip Code:77406-1794
Mailing Address - Country:US
Mailing Address - Phone:346-754-3490
Mailing Address - Fax:
Practice Address - Street 1:3415 MARLENE MEADOW WAY
Practice Address - Street 2:
Practice Address - City:RICHMOND
Practice Address - State:TX
Practice Address - Zip Code:77406-1794
Practice Address - Country:US
Practice Address - Phone:346-754-3490
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2023-07-25
Last Update Date:2023-07-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes310400000XNursing & Custodial Care FacilitiesAssisted Living Facility