Organization
CORYELL COUNTY MEMORIAL HOSPITAL AUTHORITY
Active
Other names
Gardendale Rehabilitation and Nursing Center
Organization subpart
No
Provider details
NPI number
Authorized official
MR. DAVID K BYROM (CEO)
(254) 248-6300
Entity
Organization
Contact information
Practice address
1521 E RUSK ST, JACKSONVILLE, TX 75766-5505
(903) 586-3626
(903) 586-2133
Mailing address
1521 E RUSK ST, JACKSONVILLE, TX 75766-5505
(903) 586-3626
(903) 586-2133
Taxonomy
Speciality
Code
Description
License number
State
314000000X
Skilled Nursing Facility
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
004986
—
TX
Enumeration date
07/15/2014
Last updated
07/15/2014
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