Provider Demographics
NPI:1811776602
Name:IN LOVING MEMORIES
Entity type:Organization
Organization Name:IN LOVING MEMORIES
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CNA
Authorized Official - Prefix:
Authorized Official - First Name:NASHDA
Authorized Official - Middle Name:MONIQUE
Authorized Official - Last Name:HARPER
Authorized Official - Suffix:
Authorized Official - Credentials:CNA
Authorized Official - Phone:269-544-9040
Mailing Address - Street 1:3267 COLLINGWOOD ST
Mailing Address - Street 2:
Mailing Address - City:DETROIT
Mailing Address - State:MI
Mailing Address - Zip Code:48206-1416
Mailing Address - Country:US
Mailing Address - Phone:269-544-9040
Mailing Address - Fax:
Practice Address - Street 1:10494 DUPREY ST
Practice Address - Street 2:
Practice Address - City:DETROIT
Practice Address - State:MI
Practice Address - Zip Code:48224-1226
Practice Address - Country:US
Practice Address - Phone:269-544-9040
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2023-09-21
Last Update Date:2023-09-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251E00000XAgenciesHome Health