Organization
CORYELL COUNTY MEMORIAL HOSPITAL AUTHORITY
Active
Other names
Crestview Healthcare Residence
Organization subpart
No
Provider details
NPI number
Authorized official
MR. DAVID K BYROM (CEO)
(254) 248-6300
Entity
Organization
Contact information
Practice address
1400 LAKE SHORE DR, WACO, TX 76708-3718
(254) 753-0291
(254) 753-3343
Mailing address
1400 LAKE SHORE DR, WACO, TX 76708-3718
(254) 753-0291
(254) 753-3343
Taxonomy
Speciality
Code
Description
License number
State
314000000X
Skilled Nursing Facility
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
004025
—
TX
Enumeration date
07/17/2014
Last updated
07/23/2014
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