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NPI Code Detail

MEDICARE: C.C. YOUNG MEMORIAL HOME

MEDICARE: C.C. YOUNG MEMORIAL HOME
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1251E00000XHome Health Agency003140TX

General Provider Information

NPI Number : 1326231499
Entity Type Code : Organization
Provider Name (Legal Business Name) : C.C. YOUNG MEMORIAL HOME
Provider Business Mailing Address
First Line : 4847 W LAWTHER DR
Second Line :
City : DALLAS
State : TX
Zip : 75214-1853
Country : US
Telephone Number : 214-841-2920
Fax Number : 214-841-2891
Provider Business Practice Location Address
First Line : 4849 W LAWTHER DR
Second Line :
City : DALLAS
State : TX
Zip : 75214-1879
Country : US
Telephone Number : 214-841-2825
Fax Number : 214-370-2830
Authorized Official
Title or Position : ADMINISTRATOR
Name : JENNIFER GRIFFIN
Credential :
Telephone Number : 214-841-2903
Provider Enumeration Date : 08/22/2007
Last Update Date : 03/25/2026

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Directions to “C.C. YOUNG MEMORIAL HOME ” Practice Location

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