NPIMap

Organization Active NPI

Comanche County Consolidated Hospital District

Doing business as Legacy Estate Long Term Care

  • Skilled Nursing Facility
  • Comanche, TX
National Provider Identifier
1053192245
Registry record updated Mar 5, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Skilled Nursing FacilityTaxonomy code 314000000X
Legal business name
COMANCHE COUNTY CONSOLIDATED HOSPITAL DISTRICT
Doing business as
Legacy Estate Long Term Care
Practice address
10133 Hwy 16N
Comanche, TX 76442
Phone
(254) 879-4970
NPI assigned
Oct 12, 2023
Last updated
Mar 5, 2025By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Mar 5, 2025

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name
Nikki Stark
Title
Coo
Phone
(254) 879-4970

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Skilled Nursing Facility 314000000X Primary

Addresses

Primary practice location

10133 Hwy 16N
Comanche, TX 76442

Mailing address

10133 Hwy 16N
Comanche, TX 76442
Phone (254) 879-4970

Other names 1

  • Legacy Estate Long Term Care Doing business as

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in TX

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20240312001092 TX Part A Provider - Skilled Nursing Facility 9032363411 Practice locations: Comanche, TX

NPI to CCN mapping 1

The Medicare certification numbers (CCNs) connected to NPI 1053192245. Details of each certification follow.

Skilled nursing facility certification: CCN 745054

Legal name
COMANCHE COUNTY CONSOLIDATED HOSPITAL DISTRICT
Doing business as
LEGACY ESTATE LONG TERM CARE
Certification status
Active
Provider type (POS)
Nursing home – SNF/NF dual certification
Participating since
May 24, 2024
Last certification
May 24, 2024
Beds
100
Ownership / control type
Hospital District
Organization structure
GovernmentNon-profit
Enrollment address
10133 Hwy 16
Comanche, TX 76442-4571
Nursing home name
LEGACY ESTATE LONG TERM CARE

Other NPIs with the same Medicare PAC ID 1

NPIs whose Medicare enrollments share a PECOS associate control ID (the same enrolled entity).

Care Compare: Nursing home

Medicare Care Compare
Listed as
Legacy Estate Long Term CareCCN 745054 · All quality measures
Overall star rating
4 of 5
Health inspections
4 of 5
Staffing
3 of 5
Quality measures
2 of 5
Type
Medicare and Medicaid
Ownership
Government - Hospital district
Certified
May 24, 2024
Medicare certification status
ActiveFrom the Provider of Services file
Certified beds
10076.2 residents per day on average

Processed by Care Compare on Aug 1, 2026.

Laboratory certificates & supplier records

Derived by NPIMap

These CMS records do not include an NPI. They are shown because their name and street address match this provider’s.

CLIA laboratory certificates

CLIA numberLaboratoryCertificateExpires
45D2300269Legacy Estate Long Term Care10133 Hwy 16, Comanche, TX 76442Certificate of waiverMar 5, 2028

National Provider Directory

National Provider Directory
Tax ID family
Comanche County Consolidated Hospital District13 organizations share this tax ID, including this one

Other organizations with this tax ID 12

Organizations that report the same tax identification number in the National Provider Directory.

Member organizations 1

Organizations listed as members of this organization in the National Provider Directory.

Locations

10133 Highway 16
Comanche, TX 76442
Phone (254) 879-4970

108 W Oak Ave
Comanche, TX 76442
Phone (325) 356-2509

211 S Austin St
Comanche, TX 76442
Phone (254) 842-9089

Ownership & related parties

All disclosed owners & managing parties 2

As disclosed on the Medicare enrollment (CMS All Owners files). Individuals include officers, directors and managing employees, who may not hold ownership.

NameRoleSinceShare
Elizabeth N Stark Individual Corporate OfficerCeo Apr 1, 2024
W-2 Managing EmployeeAdministrator Apr 1, 2024
Guyle P Donham Individual Adp of the SNF Nov 21, 2024

Owners & managing parties with NPI records 1

Owners and managing parties disclosed on this facility’s Medicare enrollment that are themselves Medicare-enrolled.

Practitioners & affiliated clinicians

Practitioners 10

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

Affiliated clinicians 6

Clinicians who list this facility as an affiliation in Medicare Care Compare.

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1697068800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1741132800000",
    "number": "1053192245",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "10133 HWY 16N",
            "city": "COMANCHE",
            "state": "TX",
            "postal_code": "76442",
            "telephone_number": "254-879-4970"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "10133 HWY 16N",
            "city": "COMANCHE",
            "state": "TX",
            "postal_code": "76442",
            "telephone_number": "254-879-4970"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "COMANCHE COUNTY CONSOLIDATED HOSPITAL DISTRICT",
        "organizational_subpart": "NO",
        "enumeration_date": "2023-10-12",
        "last_updated": "2025-03-05",
        "certification_date": "2025-03-05",
        "status": "A",
        "authorized_official_last_name": "STARK",
        "authorized_official_first_name": "NIKKI",
        "authorized_official_title_or_position": "COO",
        "authorized_official_telephone_number": "254-879-4970"
    },
    "taxonomies": [
        {
            "code": "314000000X",
            "taxonomy_group": "",
            "desc": "Skilled Nursing Facility",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Legacy Estate Long Term Care",
            "code": "3",
            "type": "Doing Business As"
        },
        {
            "organization_name": "Legacy Estate Long Term Care",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Comanche, TX

Sources for this page

Verify at the official NPI Registry.