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
—
—
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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