Provider Demographics
NPI:1922740851
Name:MEMORIES MATTER HOME CARE,LLC
Entity Type:Organization
Organization Name:MEMORIES MATTER HOME CARE,LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:RASHEDA
Authorized Official - Middle Name:S
Authorized Official - Last Name:DICKENS
Authorized Official - Suffix:
Authorized Official - Credentials:CNA, CMA, CDP
Authorized Official - Phone:667-688-1258
Mailing Address - Street 1:8552 HYDRA LN
Mailing Address - Street 2:
Mailing Address - City:NOTTINGHAM
Mailing Address - State:MD
Mailing Address - Zip Code:21236-3006
Mailing Address - Country:US
Mailing Address - Phone:667-688-1258
Mailing Address - Fax:
Practice Address - Street 1:8552 HYDRA LN
Practice Address - Street 2:
Practice Address - City:NOTTINGHAM
Practice Address - State:MD
Practice Address - Zip Code:21236-3006
Practice Address - Country:US
Practice Address - Phone:667-688-1258
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2022-04-11
Last Update Date:2022-04-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes251J00000XAgenciesNursing CareGroup - Multi-Specialty
No376K00000XNursing Service Related ProvidersNurse's AideGroup - Multi-Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
MD1952042236OtherNPI