# CORYELL COUNTY MEMORIAL HOSPITAL AUTHORITY

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- **Entity:** Organization
- **Status:** Active
- **Other names:** Jeffrey Place Healthcare Center
- **Organization subpart:** No

## Provider details

- **NPI number:** 1609201193
- **Authorized official:** DAVID BYROM (CEO)
- **Authorized official phone:** (254) 248-6204

## Contact information

- **Practice address:** 820 JEFFREY ST, WACO, TX 76710-4745
- **Practice address phone:** (254) 772-9480
- **Practice address fax:** (254) 772-2885
- **Mailing address:** 820 JEFFREY ST, WACO, TX 76710-4745
- **Mailing address phone:** (254) 772-9480
- **Mailing address fax:** (254) 772-2885

## Taxonomy

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

## Other

- **Enumeration date:** 09/04/2013
- **Last updated:** 09/04/2013

## Other identifiers

| Code | Description | Identifier | Issuer | State |
| --- | --- | --- | --- | --- |
| 05 | — | 004776 | — | TX |