Provider Demographics
NPI:1356831721
Name:LIBERTY COUNTY HOSPITAL DISTRICT NO. 1
Entity Type:Organization
Organization Name:LIBERTY COUNTY HOSPITAL DISTRICT NO. 1
Other - Org Name:FIVE POINTS NURSING AND REHABILITATION
Other - Org Type:Doing Business As
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:MR
Authorized Official - First Name:CHARLES
Authorized Official - Middle Name:BRUCE
Authorized Official - Last Name:STRATTON
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:936-336-7422
Mailing Address - Street 1:4150 INTERNATIONAL PLAZA
Mailing Address - Street 2:SUITE 600
Mailing Address - City:FORT WORTH
Mailing Address - State:TX
Mailing Address - Zip Code:76109-4831
Mailing Address - Country:US
Mailing Address - Phone:817-348-8959
Mailing Address - Fax:817-348-0466
Practice Address - Street 1:1625 POINT WEST PARKWAY
Practice Address - Street 2:
Practice Address - City:AMARILLO
Practice Address - State:TX
Practice Address - Zip Code:79124-4105
Practice Address - Country:US
Practice Address - Phone:806-356-0700
Practice Address - Fax:806-356-0733
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2018-05-11
Last Update Date:2022-02-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes314000000XNursing & Custodial Care FacilitiesSkilled Nursing Facility