NPIMap

Organization Active NPI

Liberty County Hospital District No 1

  • Skilled Nursing Facility
  • Livingston, TX
National Provider Identifier
1053316331
Registry record updated Aug 30, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Skilled Nursing FacilityTaxonomy code 314000000X
License
113069 Issued in TX
Legal business name
LIBERTY COUNTY HOSPITAL DISTRICT NO 1
Practice address
1620 Highway 59 Loop N
Livingston, TX 77351-9988
Phone
(936) 327-5415
NPI assigned
Jun 14, 2005
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Aug 30, 2026

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

Authorized official

Name
Charles Bruce Stratton
Title
Board President
Phone
(936) 336-7400

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Skilled Nursing Facility 314000000X 113069 TX Primary

Addresses

Primary practice location

1620 Highway 59 Loop N
Livingston, TX 77351-9988

Mailing address

1620 Highway 59 Loop N
Livingston, TX 77352-9988
Phone (817) 444-2516

Other identifiers 1

IdentifierTypeStateIssuer
001001771MedicaidTX

Other names 1

  • Pine Ridge Health Care Doing business as

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20120523000723 TX Part A Provider - Skilled Nursing Facility 9234030842 Practice locations: Livingston, TX

Skilled nursing facility certification: CCN 676000

Legal name
PINE RIDGE HEALTH CARE L L P
Certification status
Active
Provider type (POS)
Nursing home – SNF/NF distinct part
Participating since
Feb 5, 2004
Last certification
Mar 26, 2025
Beds
120
Ownership / control type
Partnership
Multi-facility organization
Oak Management Service, Inc
Organization structure
OtherProprietary
Incorporated
Jan 1, 2001 in TX
Enrollment address
1620 Highway 59 Loop N
Livingston, TX 77351-9988
Nursing home name
PINE RIDGE HEALTH CARE LLP

Care Compare: Nursing home

Medicare Care Compare
Listed as
Pine Ridge Health Care LLPCCN 676000
Overall star rating
4 of 5
Health inspections
4 of 5
Staffing
3 of 5
Quality measures
3 of 5
Type
Medicare and Medicaid
Ownership
For profit - Partnership
Certified
Feb 5, 2004
Medicare certification status
ActiveFrom the Provider of Services file
Certified beds
12065.6 residents per day on average

Processed by Care Compare on Aug 1, 2026.

National Provider Directory

National Provider Directory

Locations

1620 Highway 59 Loop N
Livingston, TX 77352
Phone (936) 327-5415

Ownership & related parties

All disclosed owners & managing parties 10

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

NameRoleSinceShare
Shin Xu Individual Operational/Managerial Control Aug 19, 2024
Adp of the SNF Feb 20, 2025
Jason Arnold Individual Corporate DirectorCoo Jan 1, 2001 100%
Adp of the SNF Jan 2, 2025
Raymond Montgomery Individual Corporate DirectorPresident Jan 1, 2001
Adp of the SNF Jan 2, 2025
Mitchell Todd Montgomery Individual Corporate OfficerCoo Jan 1, 2001 100%
Adp of the SNF Jan 2, 2025
Jeffrey L Luna Individual Operational/Managerial Control Aug 26, 2013
Adp of the SNF Feb 20, 2025
Jerry D Wood Individual Operational/Managerial Control Nov 2, 2010
Adp of the SNF Feb 20, 2025
Oak Management Organization, Azle, TX Corporation General Partnership Interest Jan 1, 2001 1%
Carlie Houston Individual Operational/Managerial Control Dec 23, 2024
Burmont, Inc. Organization, Azle, TX Corporation, Owned by another organization or individual Limited Partnership Interest Jan 1, 2001 99%
Angelina Pantel Individual Operational/Managerial Control Mar 25, 2024
Adp of the SNF Feb 20, 2025

Owners & managing parties with NPI records 3

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

Practitioners & affiliated clinicians

Practitioners 3

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

Affiliated clinicians 9

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": "1118707200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1788048000000",
    "number": "1053316331",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1620 HIGHWAY 59 LOOP N",
            "city": "LIVINGSTON",
            "state": "TX",
            "postal_code": "773529988",
            "telephone_number": "817-444-2516"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1620 HIGHWAY 59 LOOP N",
            "city": "LIVINGSTON",
            "state": "TX",
            "postal_code": "773519988",
            "telephone_number": "936-327-5415"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "LIBERTY COUNTY HOSPITAL DISTRICT NO 1",
        "organizational_subpart": "NO",
        "enumeration_date": "2005-06-14",
        "last_updated": "2026-08-30",
        "certification_date": "2026-08-30",
        "status": "A",
        "authorized_official_last_name": "STRATTON",
        "authorized_official_first_name": "CHARLES",
        "authorized_official_middle_name": "BRUCE",
        "authorized_official_title_or_position": "BOARD PRESIDENT",
        "authorized_official_telephone_number": "936-336-7400"
    },
    "taxonomies": [
        {
            "code": "314000000X",
            "taxonomy_group": "",
            "desc": "Skilled Nursing Facility",
            "state": "TX",
            "license": "113069",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "001001771",
            "state": "TX"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Pine Ridge Health Care",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Livingston, TX

Sources for this page

Verify at the official NPI Registry.