Organization
LIBERTY COUNTY HOSPITAL DISTRICT NO 1
Active
Other names
College Street Health Care Center
Organization subpart
No
Provider details
NPI number
Authorized official
CHARLES A. DAVIS (VP FINANCE)
(832) 843-5038
Entity
Organization
Contact information
Practice address
4150 COLLEGE ST, BEAUMONT, TX 77707-3902
(409) 842-2244
(409) 842-3399
Mailing address
13415 MEDICAL COMPLEX DR, SUITE 101, TOMBALL, TX 77375-3343
(832) 843-5038
(832) 843-5050
Taxonomy
Speciality
Code
Description
License number
State
314000000X
Skilled Nursing Facility
Primary
141498
TX
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
001026457
—
TX
Enumeration date
09/06/2006
Last updated
03/20/2015
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