# C C YOUNG MEMORIAL HOME

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- **Entity:** Organization
- **Status:** Active
- **Organization subpart:** No

## Provider details

- **NPI number:** 1043205479
- **Authorized official:** CATHERINE ANNE THOMAS RN (ADMIN)
- **Authorized official phone:** (214) 841-2825

## Contact information

- **Practice address:** 4849 W LAWTHER DR, DALLAS, TX 75214-1879
- **Practice address phone:** (214) 827-8080
- **Practice address fax:** (214) 370-2830
- **Mailing address:** 4847 W LAWTHER DR, SUITE \#100, DALLAS, TX 75214-1853
- **Mailing address phone:** (214) 827-8080
- **Mailing address fax:** (214) 841-2890

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 314000000X | Skilled Nursing Facility | 110990 | TX | Yes |

## Other

- **Enumeration date:** 09/12/2005
- **Last updated:** 04/04/2022

## Other identifiers

| Code | Description | Identifier | Issuer | State |
| --- | --- | --- | --- | --- |
| 05 | — | 000464001 | — | TX |