Provider Demographics
NPI:1982301917
Name:MEMORY CARE HOME HEALTH LLC
Entity Type:Organization
Organization Name:MEMORY CARE HOME HEALTH LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CEO
Authorized Official - Prefix:
Authorized Official - First Name:MEMORY
Authorized Official - Middle Name:
Authorized Official - Last Name:MAREYA
Authorized Official - Suffix:
Authorized Official - Credentials:RN
Authorized Official - Phone:614-377-2484
Mailing Address - Street 1:8111 ROYAL ELM DR
Mailing Address - Street 2:
Mailing Address - City:BLACKLICK
Mailing Address - State:OH
Mailing Address - Zip Code:43004-5054
Mailing Address - Country:US
Mailing Address - Phone:614-377-2484
Mailing Address - Fax:
Practice Address - Street 1:8111 ROYAL ELM DR
Practice Address - Street 2:
Practice Address - City:BLACKLICK
Practice Address - State:OH
Practice Address - Zip Code:43004-5054
Practice Address - Country:US
Practice Address - Phone:614-377-2484
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2023-02-09
Last Update Date:2023-02-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251E00000XAgenciesHome Health