Provider Demographics
NPI:1740018878
Name:K MEMORY CARE INC
Entity type:Organization
Organization Name:K MEMORY CARE INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:MS
Authorized Official - First Name:NAMKYUNG
Authorized Official - Middle Name:
Authorized Official - Last Name:LEE
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:718-888-2222
Mailing Address - Street 1:16213 46 AVENUE
Mailing Address - Street 2:2ND AND 3RD FLOOR
Mailing Address - City:FLUSHING
Mailing Address - State:NY
Mailing Address - Zip Code:11358-3698
Mailing Address - Country:US
Mailing Address - Phone:718-431-3555
Mailing Address - Fax:
Practice Address - Street 1:16213 46 AVENUE
Practice Address - Street 2:2ND AND 3RD FLOOR
Practice Address - City:FLUSHING
Practice Address - State:NY
Practice Address - Zip Code:11358-3698
Practice Address - Country:US
Practice Address - Phone:718-431-3555
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2024-07-22
Last Update Date:2024-10-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QA0600XAmbulatory Health Care FacilitiesClinic/CenterAdult Day Care