MEMORY LANE
NPI 1376854372
Assisted Living Facility in Bowdon, GA

Q: What is Southeast Senior Care Mangment Group's NPI number?

The NPI number for Southeast Senior Care Mangment Group is 1376854372. It was assigned to this organization in the NPPES registry on June 24, 2010. The provider is doing business as Memory Lane.

Q: What is Southeast Senior Care Mangment Group's specialty?

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

Active since June 24, 2010

501 MITCHELL AVE, BOWDON, GA 30108(770) 258-8600 Get Directions Write a Review

NPPES record last updated: June 24, 2010. Verified against the NPPES registry weekly; last sync: August 23, 2026.

On this page

About Memory Lane NPPES

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

MEMORY LANE (NPI 1376854372) is a healthcare organization registered as an assisted living facility in Bowdon, Georgia and active in the NPI registry since June 2010. The organization lists John Cheney, Ceo, as its authorized official.

NPPES Registry Identity

NPI1376854372

Entity TypeOrganization

Primary Taxonomy310400000X

Legal Business NameSOUTHEAST SENIOR CARE MANGMENT GROUP

Location Address501 MITCHELL AVEBowdon, GA 30108-1407

Mailing Address501 Mitchell AveBowdon, GA 30108-1407 · (770) 258-8600

Phone(770) 258-8600

Organization SubpartNo

Authorized OfficialJohn CheneyCeo · (770) 258-8600

Enumeration DateJune 24, 2010

✔ NPI 1376854372 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyAssisted Living FacilityNursing & Custodial Care Facilities

Taxonomy Code310400000X

License✔ Licensed in GA · 022-03-010-9

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.

501 MITCHELL AVE, Bowdon, GA 30108

Open in Google Maps ↗

Other Names 1

Doing Business AsMemory Lane

Other Providers at the Same Location NPPES

Providers registered at the same practice address, or within the immediate area, according to the NPPES registry.

DEBORAH L. PREMENTINE LPTA

Physical Therapy Assistant

501 MITCHELL AVE
BOWDON, GA 30108

Carroll County (678) 890-9965

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 Southeast Senior Care Mangment Group's NPI number?

The NPI number for Southeast Senior Care Mangment Group is 1376854372. It was assigned to this organization in the NPPES registry on June 24, 2010. The provider is doing business as Memory Lane.

Where is Southeast Senior Care Mangment Group located?

Southeast Senior Care Mangment Group is located at 501 Mitchell Ave, Bowdon, GA 30108. The listed phone number is (770) 258-8600.

What is Southeast Senior Care Mangment Group'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 Southeast Senior Care Mangment Group was last updated on June 24, 2010. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 16 years 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.