Healthcare Provider Details

I. General information

NPI: 1225944424
Provider Name (Legal Business Name): LIFECARE MEMORY PARTNERS
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 08/19/2026
Last Update Date: 08/19/2026
Certification Date: 08/19/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1314 3RD AVE
CONWAY SC
29526-5002
US

IV. Provider business mailing address

1414 PHYSICIANS DR
WILMINGTON NC
28401-7335
US

V. Phone/Fax

Practice location:
  • Phone: 910-796-7900
  • Fax: 910-341-1908
Mailing address:
  • Phone: 910-796-7900
  • Fax: 910-341-1908

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code251B00000X
TaxonomyCase Management Agency
License Number
License Number State

VIII. Authorized Official

Name: JASON PISANI
Title or Position: VP FINANCE
Credential:
Phone: 910-796-7952