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Organization

MEMORY LANE COTTAGE AT TAMPA PALMS, LLC

Active
Other names
Memory Lane Cottage
Organization subpart
No

Provider details

NPI number
Authorized official
KELLY JEAN IRISH (ADMINISTRATOR)
(813) 632-1270
Entity
Organization

Contact information

Practice address
5175 CYPRESS PRESERVE DR, TAMPA, FL 33647-3674
(813) 632-1270
(813) 632-1272
Mailing address
5175 CYPRESS PRESERVE DR, TAMPA, FL 33647-3674
(813) 632-1270
(813) 632-1272

Taxonomy

Speciality
Code
Description
License number
State
310400000X
Assisted Living Facility
Primary

Other

Enumeration date
07/18/2015
Last updated
09/12/2023
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