Provider Demographics
NPI:1528505484
Name:FORGET ME NOT LIFE CARE SERVICES LLC
Entity type:Organization
Organization Name:FORGET ME NOT LIFE CARE SERVICES LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER/PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:GLORIA
Authorized Official - Middle Name:
Authorized Official - Last Name:CRAWFORD
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:901-337-0002
Mailing Address - Street 1:PO BOX 6083
Mailing Address - Street 2:
Mailing Address - City:MCKINNEY
Mailing Address - State:TX
Mailing Address - Zip Code:75071-5103
Mailing Address - Country:US
Mailing Address - Phone:901-337-0002
Mailing Address - Fax:
Practice Address - Street 1:6653 MCKINNEY RANCH PKWY
Practice Address - Street 2:#3302
Practice Address - City:MCKINNEY
Practice Address - State:TX
Practice Address - Zip Code:75070-2168
Practice Address - Country:US
Practice Address - Phone:901-337-0002
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2017-01-30
Last Update Date:2017-01-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes253Z00000XAgenciesIn Home Supportive Care