# CITIZENS MEDICAL CENTER COUNTY OF VICTORIA

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- **Entity:** Organization
- **Status:** Active
- **Other names:** SOUTHBROOKE MANOR NURSING AND REHABILITATION CENTER
- **Organization subpart:** No

## Provider details

- **NPI number:** 1801217997
- **Authorized official:** MR. MICHAEL OLSON (CEO/ADMINISTRATOR)
- **Authorized official phone:** (361) 573-9181

## Contact information

- **Practice address:** 1401 W MAIN ST, EDNA, TX 77957-2454
- **Practice address phone:** (361) 782-7614
- **Practice address fax:** (833) 217-5345
- **Mailing address:** 2701 HOSPITAL DR, VICTORIA, TX 77901-5748
- **Mailing address phone:** (361) 573-9181
- **Mailing address fax:** (361) 572-5126

## Taxonomy

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

## Other

- **Enumeration date:** 12/17/2013
- **Last updated:** 05/13/2026

## Other identifiers

| Code | Description | Identifier | Issuer | State |
| --- | --- | --- | --- | --- |
| 05 | — | 001025756 | — | TX |
| 05 | — | 361148501 | — | TX |
| 05 | — | 5302 | — | TX |