- Enrollment id
- O20140310000464
- Enrollment state
- TX
- Provider type code
- 00-18
- Provider type text
- PART A PROVIDER - SKILLED NURSING FACILITY
- Npi
- 1548690878
- Multiple npi flag
- N
- Ccn
- 676227
- Associate id
- 7719886282
- Organization name
- CORYELL COUNTY MEMORIAL HOSPITAL AUTHORITY
- Doing business as name
- COPPERAS HOLLOW NURSING AND REHABILITATION CENTER
- Organization type structure
- OTHER
- Organization other type text
- HOSPITAL AUTHORITY
- Proprietary nonprofit
- N
- Nursing home provider name
- COPPERAS HOLLOW NURSING & REHABILITATION CENTER
- Affiliation entity name
- CREATIVE SOLUTIONS IN HEALTHCARE
- Affiliation entity id
- 169
- Address line 1
- 345 COUNTRY CLUB DR
- City
- CALDWELL
- State
- TX
- Zip code
- 778362328