Provider Demographics
NPI:1912125683
Name:LIBERTY COUNTY HOSPITAL DISTRICT NO 1
Entity Type:Organization
Organization Name:LIBERTY COUNTY HOSPITAL DISTRICT NO 1
Other - Org Name:THE COURTYARDS AT PASADENA
Other - Org Type:Doing Business As
Authorized Official - Title/Position:BOARD PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:C
Authorized Official - Middle Name:BRUCE
Authorized Official - Last Name:STRATTON
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:713-477-7877
Mailing Address - Street 1:4048 RED BLUFF RD
Mailing Address - Street 2:
Mailing Address - City:PASADENA
Mailing Address - State:TX
Mailing Address - Zip Code:77503-3606
Mailing Address - Country:US
Mailing Address - Phone:713-477-7877
Mailing Address - Fax:
Practice Address - Street 1:4048 RED BLUFF ROAD
Practice Address - Street 2:
Practice Address - City:PASADENA
Practice Address - State:TX
Practice Address - Zip Code:77503
Practice Address - Country:US
Practice Address - Phone:713-477-7877
Practice Address - Fax:713-477-7809
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-04-20
Last Update Date:2020-04-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes314000000XNursing & Custodial Care FacilitiesSkilled Nursing Facility
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX001015147Medicaid
676155Medicare Oscar/Certification