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Organization
MEMORIAL MEDICAL CENTER
Active
Organization
MEMORIAL MEDICAL CENTER
Active
Other names
Lavaca Bay Nursing and Rehabilitation Center
Organization subpart
No
Provider details
NPI number
Authorized official
ERIN CLEVENGER (CEO)
(361) 552-0454
Entity
Organization
Contact information
Practice address
118 TRINITY SHORES DRIVE, PORT LAVACA, TX 77979
(361) 551-0500
Mailing address
815 N VIRGINIA ST, PORT LAVACA, TX 77979-3025
(361) 552-0224
Taxonomy
Speciality
Code
Description
License number
State
314000000X
Skilled Nursing Facility
Primary
—
NULL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
001030947
—
TX
05
—
110301
—
TX
05
—
5808
—
TX
Enumeration date
09/18/2019
Last updated
05/13/2026
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