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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, Inpatient - 315D00000X
Entity Type: Organization

CLIA Number: 45D0479405

Address:
4829 W. LAWTHER DR
DALLAS, TX
ZIP 75214
Phone: (214) 841-2825
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C.C. YOUNG MEMORIAL HOME is a hospice inpatient in Dallas, TX. The provider is a provider organization, or distinct part of the organization, which renders an interdisciplinary program providing palliative care, chiefly medical relief of pain and supporting services, which addresses the emotional, social, financial, and legal needs of terminally ill patients and their families where an institutional care environment is required for the patient. 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:

4829 W. LAWTHER DR
DALLAS, TX
ZIP 75214
Phone: (214) 841-2825
Fax: (214) 273-9671

The provider's authorized official is Russell Crews .
The authorized official title is President & Ceo and has the following contact phone number (214) 841-2819.

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 9/16/2015.


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 CodeTaxonomy ClasificationTaxonomy SpecializationLicense NumberLicense StatePrimary
1315D00000XHospice, Inpatient451790TEXASYes

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 IdentifierOther Provider Identifier TypeOther Provider Identifier StateOther Provider Identifier Issuer
1001013912MEDICAIDTEXAS
2451790MEDICARE ID-TYPE UNSPECIFIEDTEXASHOSPICE CARE

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: 11/14/2023

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