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General NPI Number Information
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NPI Number | 1912125683
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Entity Type | Organization
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Legal Business Name | LIBERTY COUNTY HOSPITAL DISTRICT NO 1
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Dates
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Enumeration Date | 04/20/2007
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Last Update Date | 04/23/2020
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Provider Practice Location Address
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Address Line | 4048 RED BLUFF ROAD
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City | PASADENA
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State | TX
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Zip | 77503
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Country | US
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Telephone | 713-477-7877
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Fax | 713-477-7809
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Provider Business Mailing Address
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Address Line | 4048 RED BLUFF RD
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City | PASADENA
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State | TX
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Zip | 77503-3606
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Country | US
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Telephone | 713-477-7877
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Fax |
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Authorized Official
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Title or Position | BOARD PRESIDENT
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Name | C BRUCE STRATTON
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Credential |
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Telephone | 713-477-7877
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 314000000X
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Taxonomy Name | Skilled Nursing Facility
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License Number |
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License Number State |
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