Organization
MEMORY LANE AT HOME AGENCY
Active
Organization subpart
No
Provider details
NPI number
Authorized official
TAMARA CLARK (OWNER)
(901) 207-2260
Entity
Organization
Contact information
Practice address
254 COURT AVE, MEMPHIS, TN 38103-2361
(901) 207-2260
Mailing address
254 COURT AVE # 205, MEMPHIS, TN 38103-2361
(901) 221-4430
(901) 207-2260
Taxonomy
Speciality
Code
Description
License number
State
253Z00000X
In Home Supportive Care Agency
—
—
385H00000X
Respite Care
Primary
—
—
Other
Enumeration date
05/03/2019
Last updated
11/05/2025
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