Memory Lane Assisted Living
NPI 1114722097ActiveOrganization· Assisted Living Facility· Apple Valley, MN
Assisted Living Facility in Apple Valley, Minnesota, registered in NPPES in February 2025. The authorized official on file is Abdiasis Hirsi, Director.
Overview
| NPI | 1114722097 |
|---|---|
| Status | Active |
| Entity type | Organization |
| NPI issued | Feb 15, 2025 |
| Last updated in NPPES | Feb 15, 2025 |
| Certified by provider | Feb 15, 2025 |
Specialties and licenses
| Taxonomy | Code | License | State |
|---|---|---|---|
| Assisted Living Facility Primary | 310400000X | — | — |
| In Home Supportive Care | 253Z00000X | — | — |
| Respite Care | 385H00000X | — | — |
Exclusion screening
| List | Result | Details |
|---|---|---|
| HHS-OIG LEIE · Oct 9, 2026 | No match | Checked by NPI and by name + state |
| North Carolina Medicaid · Nov 10, 2026 | No match | — |
| New York OMIG · Nov 10, 2026 | No match | — |
| Ohio Medicaid · Nov 10, 2026 | No match | — |
| Pennsylvania Medicheck · Nov 10, 2026 | No match | — |
| Washington HCA · Nov 10, 2026 | No match | — |
Official OIG search · How matching works ·Bulk check a roster
Medicare
| Enrollment (PECOS) | Not in the public enrollment file of Oct 1, 2026 |
|---|
Other Assisted Living Facility providers in Apple Valley
- 1518657675
- 1144091901
- 1417892464
- 1083767446
- 1679124663
- 1538373048
- 1649120023
- 1528936002
- 1639349137
- 1053957134
- 1073838363
- 1821663170