Healthcare Provider Details

I. General information

NPI: 1447205646
Provider Name (Legal Business Name): LIBERTY COUNTY HOSPITAL DISTRICT NO. 1
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 05/24/2006
Last Update Date: 08/21/2024
Certification Date: 08/21/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

103 TEAKWOOD
CENTERVILLE TX
75833-2497
US

IV. Provider business mailing address

6937 WARFIELD AVE
SYKESVILLE MD
21784-7454
US

V. Phone/Fax

Practice location:
  • Phone: 903-536-2596
  • Fax: 903-536-3225
Mailing address:
  • Phone: 410-552-4800
  • Fax: 410-552-4837

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code314000000X
TaxonomySkilled Nursing Facility
License Number
License Number StateTX

VIII. Authorized Official

Name: CHARLES BRUCE STRATTON
Title or Position: BOARD PRESIDENT
Credential:
Phone: 936-336-7400