Memory Lane Assisted Living
Memory Lane Assisted Living is a healthcare organization registered as Assisted Living Facility in Apple Valley, MN, holding Type 2 (organization) NPI 1114722097 since 2025. The authorized official on file is Abdiasis Hirsi, Director.
✓ Active NPI ✓ Valid NPI checksum
| NPI | 1114722097 |
|---|---|
| Entity type | Organization (Type 2) |
| Legal business name | Memory Lane Assisted Living |
| Practice address | 15117 EMORY CIR, Apple Valley, MN, 55124 |
| Phone | 6122980555 |
| Enumeration date | 2025-02-15 |
| Last updated in NPPES | 2025-02-15 |
Authorized official
| Name | Abdiasis Hirsi |
|---|---|
| Title | Director |
| Phone | 6122980555 |
Taxonomy & classification
| Taxonomy code | Specialty | Primary | License | State |
|---|---|---|---|---|
| 253Z00000X | In Home Supportive Care Agency | Secondary | — | — |
| 385H00000X | Respite Care | Secondary | — | — |
| 310400000X | Assisted Living Facility | Primary | — | — |
Copy-ready billing details
Provider: Memory Lane Assisted Living NPI: 1114722097 Taxonomy: 310400000X (Assisted Living Facility) Address: 15117 EMORY CIR, Apple Valley, MN, 55124
Verify this record
Cross-check NPI 1114722097 against the authoritative CMS record: view Memory Lane Assisted Living on the official NPPES registry .
What is an NPI number?
A National Provider Identifier (NPI) is a unique 10-digit number that CMS assigns to every U.S. healthcare provider and organization under HIPAA. Type 1 NPIs identify individual providers; Type 2 NPIs identify organizations. The NPI appears on insurance claims, prescriptions, and credentialing paperwork, and never changes — even if the provider moves or changes specialty. Read the full guide or validate an NPI number.
Frequently asked questions
What type of organization is Memory Lane Assisted Living?
What is a Type 2 NPI?
Source: CMS NPPES (public data). Snapshot 2026-07-11. Provider record last updated 2025-02-15.