MEMORY LANE ASSISTED LIVING
NPI 1114722097
Assisted Living Facility in Apple Valley, MN

Q: What is Memory Lane Assisted Living's NPI number?

The NPI number for Memory Lane Assisted Living is 1114722097. It was assigned to this organization in the NPPES registry on February 15, 2025.

Q: What is Memory Lane Assisted Living's specialty?

The primary specialty registered for this NPI is Assisted Living Facility with taxonomy code 310400000X.

Active since February 15, 2025

15117 EMORY CIR, APPLE VALLEY, MN 55124(612) 298-0555 Get Directions Write a Review

NPPES record last updated: February 15, 2025. Verified against the NPPES registry weekly; last sync: August 09, 2026.

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About Memory Lane Assisted Living NPPES

Official registry information on file with the National Plan and Provider Enumeration System.

MEMORY LANE ASSISTED LIVING (NPI 1114722097) is a healthcare organization registered as an assisted living facility in Apple Valley, Minnesota and active in the NPI registry since February 2025. The organization lists Abdiasis Hirsi, Director, as its authorized official.

NPPES Registry Identity

NPI1114722097

Entity TypeOrganization

Primary Taxonomy310400000X

Legal Business NameMEMORY LANE ASSISTED LIVING

Location Address15117 EMORY CIRApple Valley, MN 55124-1808

Mailing Address15117 Emory CirApple Valley, MN 55124-1808 · (612) 298-0555

Phone(612) 298-0555

Organization SubpartNo

Authorized OfficialAbdiasis HirsiDirector · (612) 298-0555

Enumeration DateFebruary 15, 2025

NPPES CertifiedFebruary 15, 2025

✔ NPI 1114722097 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses 3

★ Primary SpecialtyAssisted Living FacilityNursing & Custodial Care Facilities

Taxonomy Code310400000X

Definition

A facility providing supportive services to individuals who can function independently in most areas of activity, but need assistance and/or monitoring to assure safety and well being.

Also ListedIn Home Supportive CareTaxonomy 253Z00000X

Also ListedRespite CareTaxonomy 385H00000X

15117 EMORY CIR, Apple Valley, MN 55124

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Frequently Asked Questions NPPES & CMS

Common questions about this NPI record, answered from the official NPPES registry and CMS datasets shown on this page.

What is Memory Lane Assisted Living's NPI number?

The NPI number for Memory Lane Assisted Living is 1114722097. It was assigned to this organization in the NPPES registry on February 15, 2025.

Where is Memory Lane Assisted Living located?

Memory Lane Assisted Living is located at 15117 Emory Cir, Apple Valley, MN 55124. The listed phone number is (612) 298-0555.

What is Memory Lane Assisted Living's specialty?

The primary specialty registered for this NPI is Assisted Living Facility with taxonomy code 310400000X.

When was this NPI record last updated?

The NPPES record for Memory Lane Assisted Living was last updated on February 15, 2025. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 17 months ago. If this record has changed at CMS more recently, you can request an on-demand re-check against the live CMS registry, directly from this page.