Organization
LIBERTY- DAYTON REGIONAL MEDICAL CENTER LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MRS. VICKI A GATES RN (CEO)
(936) 336-7316
Entity
Organization
Contact information
Practice address
1353 NORTH TRAVIS STREET, LIBERTY, TX 77575-3549
(936) 336-7316
(936) 336-7772
Mailing address
1353 NORTH TRAVIS STREET, LIBERTY, TX 77575-3549
(936) 336-7316
(936) 336-7772
Taxonomy
Speciality
Code
Description
License number
State
275N00000X
Medicare Defined Swing Bed Hospital Unit
Primary
100072
TX
275N00000X
Medicare Defined Swing Bed Hospital Unit
—
—
Other
Enumeration date
11/21/2006
Last updated
04/18/2011
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