# LIBERTY COUNTY HOSPITAL DISTRICT NO 1

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- **Entity:** Organization
- **Status:** Active
- **Other names:** College Street Health Care Center
- **Organization subpart:** No

## Provider details

- **NPI number:** 1326141557
- **Authorized official:** CHARLES A. DAVIS (VP FINANCE)
- **Authorized official phone:** (832) 843-5038

## Contact information

- **Practice address:** 4150 COLLEGE ST, BEAUMONT, TX 77707-3902
- **Practice address phone:** (409) 842-2244
- **Practice address fax:** (409) 842-3399
- **Mailing address:** 13415 MEDICAL COMPLEX DR, SUITE 101, TOMBALL, TX 77375-3343
- **Mailing address phone:** (832) 843-5038
- **Mailing address fax:** (832) 843-5050

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 314000000X | Skilled Nursing Facility | 141498 | TX | Yes |

## Other

- **Enumeration date:** 09/06/2006
- **Last updated:** 03/20/2015

## Other identifiers

| Code | Description | Identifier | Issuer | State |
| --- | --- | --- | --- | --- |
| 05 | — | 001026457 | — | TX |