Provider Demographics
NPI:1235100058
Name:CHAMBERS COUNTY PUBLIC HOSPITAL DISTRICT NO 1
Entity Type:Organization
Organization Name:CHAMBERS COUNTY PUBLIC HOSPITAL DISTRICT NO 1
Other - Org Name:BRIGHTON SENIOR LIVING AT REGENCY VILLAGE
Other - Org Type:Doing Business As
Authorized Official - Title/Position:CEO
Authorized Official - Prefix:MR
Authorized Official - First Name:ROBERT
Authorized Official - Middle Name:
Authorized Official - Last Name:PASCASIO
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:409-267-3143
Mailing Address - Street 1:409 WEST GREENE ST
Mailing Address - Street 2:
Mailing Address - City:WEBSTER
Mailing Address - State:TX
Mailing Address - Zip Code:77598-6701
Mailing Address - Country:US
Mailing Address - Phone:281-332-4738
Mailing Address - Fax:281-332-5449
Practice Address - Street 1:409 GREENE ST
Practice Address - Street 2:
Practice Address - City:WEBSTER
Practice Address - State:TX
Practice Address - Zip Code:77598-6701
Practice Address - Country:US
Practice Address - Phone:281-332-4738
Practice Address - Fax:281-332-5449
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-01-30
Last Update Date:2023-01-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX112588314000000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes314000000XNursing & Custodial Care FacilitiesSkilled Nursing Facility
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX67-5961Medicare ID - Type UnspecifiedMEDICARE PROVIDER NUMBER