NPIMap

Comanche County Consolidated Hospital District

Organization Active NPI Skilled Nursing Facility · Comanche, TX

NPI 1053192245 · NPPES record last updated Mar 5, 2025

Key facts

NPI
1053192245
Entity type
Organization (NPI type 2)
Primary specialty
Skilled Nursing Facility 314000000X
Legal business name
COMANCHE COUNTY CONSOLIDATED HOSPITAL DISTRICT
Practice address
10133 Hwy 16N
Comanche, TX 76442
Phone
(254) 879-4970
NPI assigned
Oct 12, 2023
Organization subpart
No

Authorized official

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

Owners & managing parties with NPI records 1

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

Other NPIs with the same Medicare PAC ID 1

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

Corporate family (same 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.

Practitioners 10

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

Affiliated clinicians 6

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

Medicare Care Compare: Nursing home

Listed as
Legacy Estate Long Term Care CCN 745054
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
Active (Provider of Services file)
Certified beds
100 · 76.2 residents per day on average

Source: Medicare Care Compare, processed Aug 1, 2026.

Laboratory certificates & supplier records

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

CLIA laboratory certificates

CLIA numberLaboratoryCertificateExpires
45D2300269Legacy Estate Long Term Care
10133 Hwy 16, Comanche, TX 76442		Certificate of waiverMar 5, 2028

Medicare participation

Medicare fee-for-service enrollment
Enrolled in TX

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
Government · Non-profit
Enrollment address
10133 Hwy 16
Comanche, TX 76442-4571
Nursing home name
LEGACY ESTATE LONG TERM CARE

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 Officer
Ceo		 Apr 1, 2024
W-2 Managing Employee
Administrator		 Apr 1, 2024
Guyle P Donham
Individual 		Adp of the SNF Nov 21, 2024

Medicare enrollment records

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

National Provider Directory

Tax ID family
Comanche County Medical Center (13 organizations share this tax ID)

Locations

210 S Houston St
Comanche, TX 76442

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

407S Texas St
De Leon, TX 76444
Phone (254) 893-2011

Specialties & licenses

Specialty (taxonomy)CodeLicenseStatePrimary
Skilled Nursing Facility 314000000X Yes

Addresses

Primary practice location

10133 Hwy 16N
Comanche, TX 76442

Mailing address

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

Other names

  • Legacy Estate Long Term Care Doing business as

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API JSON format, last updated by the provider on Mar 5, 2025.

{
    "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

All providers in Comanche, TX · Skilled Nursing Facility in Texas

Sources for this page

Verify at the official NPI Registry.