C.C. YOUNG MEMORIAL HOME NPI 1700083524

NPI Information

NPI: 1700083524
Provider Name: C.C. YOUNG MEMORIAL HOME

Doing Business As: C.C. YOUNG HOME HEALTH AND HOSPICE

Classification: Hospice Care, Community Based - 251G00000X
Entity Type: Organization

Address:
4849 W LAWTHER DR
DALLAS, TX
ZIP 75214
Phone: (214) 841-2825
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C.C. YOUNG MEMORIAL HOME is a hospice care community based in Dallas, TX. C.C. YOUNG MEMORIAL HOME NPI is 1700083524. The provider is registered as an organization entity type.
The provider Is Doing Business As C.c. Young Home Health And Hospice.

The provider's business location address is:

4849 W LAWTHER DR
DALLAS, TX
ZIP 75214-879
Phone: (214) 841-2825
Fax: (214) 370-2830

The provider's authorized official is Catherine Anne Thomas .
The authorized official title is Administrator and has the following contact phone number (214) 841-2825.

The CLIA number assigned to this NPI record is 45D0479405 - home health agency with a certificate type of Certificate of Waiver.

The enumeration date for this NPI number is 6/27/2007 and was last updated on 4/4/2022.

Taxonomy Codes

The NPI record includes the healthcare provider taxonomy classification, state license number and state of licensure. The following information regarding the scope of practice of this provider is available:

No.	Taxonomy Code	Taxonomy Clasification	Taxonomy Specialization	License Number	License State	Primary
1	315D00000X	Hospice, Inpatient		451790	TEXAS	No
2	251G00000X	Hospice Care, Community Based				Yes

Other Identifiers

The following information regarding additional identifiers associated to this NPI record includes the other identifier number, identifier type, identifier state and issuer.

No.	Other Provider Identifier	Other Provider Identifier Type	Other Provider Identifier State	Other Provider Identifier Issuer
1	001013912	MEDICAID	TEXAS

What is NPI?

NPI stands for National Provider Identifier. The NPI is a 10-digit identification number that is completely unique. The NPI number by itself does not contain any identifiable information such as a provider’s speciality or location. The NPI is assigned to individuals or organizacions for their lifespan and it is independent of key provider information type updates like a change of practices, location or speciality.

This page was last updated on: 5/5/2024

NPI Synchronization or Removal

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