NPIMap

Organization Active NPI

Childress County Hospital District

Doing business as Villa Haven Health and Rehabililitation Center

  • Skilled Nursing Facility
  • Breckenridge, TX
National Provider Identifier
1770780223
Registry record updated May 25, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Skilled Nursing FacilityTaxonomy code 314000000X
Legal business name
CHILDRESS COUNTY HOSPITAL DISTRICT
Doing business as
Villa Haven Health and Rehabililitation Center
Practice address
300 S Jackson St
Breckenridge, TX 76424-4804
Phone
(254) 559-3386
NPI assigned
Jun 28, 2007
Last updated
May 25, 2021By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on May 25, 2021

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

Authorized official

Name
Holly Holcomb
Title
Ceo
Phone
(940) 937-6371

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Skilled Nursing Facility 314000000X NU Primary

Addresses

Primary practice location

300 S Jackson St
Breckenridge, TX 76424-4804

Mailing address

920 Ridgebrook Rd
Sparks, MD 21152-9390
Phone (410) 773-1000

Other identifiers 1

IdentifierTypeStateIssuer
001015195MedicaidTX

Other names 1

  • Villa Haven Health and Rehabililitation Center Doing business as

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20170422000006 TX Part A Provider - Skilled Nursing Facility 5193634111 Practice locations: Breckenridge, TX

NPI to CCN mapping 1

The Medicare certification numbers (CCNs) connected to NPI 1770780223. Details of each certification follow.

Skilled nursing facility certification: CCN 675279

Legal name
CHILDRESS COUNTY HOSPITAL DISTRICT
Doing business as
VILLA HAVEN HEALTH AND REHABILITATION CENTER
Certification status
Active
Provider type (POS)
Nursing home – SNF/NF distinct part
Participating since
Mar 18, 1994
Last certification
Dec 19, 2024
Beds
92
Ownership / control type
Hospital District
Organization structure
GovernmentNon-profit
Enrollment address
300 S Jackson St
Breckenridge, TX 76424-4804
Nursing home name
VILLA HAVEN HEALTH AND REHABILITATION CENTER
Affiliated entity
FUNDAMENTAL HEALTHCARE

Other NPIs with the same Medicare PAC ID 18

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

View all 18

Care Compare: Nursing home

Medicare Care Compare
Listed as
Villa Haven Health and Rehabilitation CenterCCN 675279 · All quality measures
Overall star rating
5 of 5
Health inspections
5 of 5
Staffing
1 of 5
Quality measures
5 of 5
Type
Medicare and Medicaid
Ownership
Government - Hospital district
Certified
Mar 18, 1994
Medicare certification status
ActiveFrom the Provider of Services file
Certified beds
9233.3 residents per day on average
Chain
Fundamental Healthcare66 facilities in the chain

Processed by Care Compare on Aug 1, 2026.

National Provider Directory

National Provider Directory
Tax ID family
Childress Regional Medi26 organizations share this tax ID, including this one

Other organizations with this tax ID 25

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

View all 25

Locations

300 S Jackson St
Breckenridge, TX 76424
Phone (254) 559-3368

Ownership & related parties

All disclosed owners & managing parties 11

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

NameRoleSinceShare
William E Prater Individual Operational/Managerial Control Aug 1, 2025
Adp of the SNF Aug 1, 2025
Breckeridgetx LLC Organization, Southlake, TX LLC Operational/Managerial Control Aug 1, 2025
Texas Senior Realty Ventures LLC Organization, Southlake, TX LLC Adp of the SNF Aug 1, 2025
300 South Jackson LLC Organization, Southlake, TX LLC Adp of the SNF Aug 1, 2025
Empower Opco LLC Organization, Southlake, TX LLC Adp of the SNF Aug 1, 2025
Childress County Hospital District Organization, Childress, TX 5% Or Greater Direct Ownership Interest Apr 1, 2017 100%
Emilee Stratton Individual Corporate OfficerCfo Mar 18, 2018
Deanne Gray Individual Operational/Managerial Control Mar 20, 2023
Adp of the SNF Mar 20, 2023
Mary F Pfeifer Individual Operational/Managerial Control Aug 1, 2025
Empower Healthcare Management LLC Organization, Southlake, TX LLC Adp of the SNF Aug 1, 2025
Holly Holcomb Individual Corporate OfficerCeo May 29, 2021

Owners & managing parties with NPI records 19

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

View all 19

All facility ownership & control disclosures 14

Facilities whose Medicare enrollment lists this provider’s PECOS associate ID as an owner or managing party.

FacilityTypeRoleSince
Childress Regional Medical CenterChildress, TX, CCN 450369 Hospital Operational/Managerial Control Dec 29, 1986
Avir at ChildressChildress, TX, CCN 675055 Skilled nursing facility 5% Or Greater Direct Ownership Interest (100%) Sep 30, 2014
Prairie House Living CenterPlainview, TX, CCN 675478 Skilled nursing facility Operational/Managerial Control Sep 1, 2014
Ralls Nursing HomeRalls, TX, CCN 675407 Skilled nursing facility 5% Or Greater Indirect Ownership Interest
Adp of the SNF		 Dec 1, 2014
Jan 23, 2025
Apex Secure Care BrownfieldBrownfield, TX, CCN 675019 Skilled nursing facility 5% Or Greater Indirect Ownership Interest
Adp of the SNF		 Dec 1, 2014
Jan 23, 2025
Landmark of Amarillo Rehabilitation and Nursing CenterAmarillo, TX, CCN 455675 Skilled nursing facility 5% Or Greater Direct Ownership Interest (100%) Sep 1, 2017
Crowell Nursing CenterCrowell, TX, CCN 675013 Skilled nursing facility Operational/Managerial Control Apr 1, 2017
Willowcreek Rehab and NursingAbilene, TX, CCN 675350 Skilled nursing facility 5% Or Greater Direct Ownership Interest (100%) Apr 1, 2017
Matador Health and Rehabilitation CenterMatador, TX, CCN 676389 Skilled nursing facility 5% Or Greater Direct Ownership Interest (100%) Apr 1, 2018
Wellington Care CenterWellington, TX, CCN 675945 Skilled nursing facility 5% Or Greater Direct Ownership Interest (100%) Apr 1, 2024
Memphis Convalescent CenterMemphis, TX, CCN 675970 Skilled nursing facility 5% Or Greater Direct Ownership Interest (100%) Apr 1, 2024
Childress Regional Medical Center Home HealthChildress, TX, CCN 457489 Home health agency 5% Or Greater Direct Ownership Interest (100%) Jul 31, 1983
Childress Regional Medical Center HospiceChildress, TX, CCN 451658 Hospice Operational/Managerial Control (100%) Nov 13, 1996
Fox Rural Health ClinicChildress, TX, CCN 453996 Rural health clinic Operational/Managerial Control Jun 25, 2008

Owned or controlled facilities with NPI records 16

Facilities whose Medicare enrollment lists this provider as an owner, officer, director or managing party.

View all 16

Facilities with the same owner 14

Facilities that share an organizational owner with 5% or greater ownership or operational control.

View all 14

Practitioners & affiliated clinicians

Practitioners 3

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 3

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": "1182988800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1621900800000",
    "number": "1770780223",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "920 RIDGEBROOK RD",
            "city": "SPARKS",
            "state": "MD",
            "postal_code": "211529390",
            "telephone_number": "410-773-1000"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "300 S JACKSON ST",
            "city": "BRECKENRIDGE",
            "state": "TX",
            "postal_code": "764244804",
            "telephone_number": "254-559-3386"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "CHILDRESS COUNTY HOSPITAL DISTRICT",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-06-28",
        "last_updated": "2021-05-25",
        "certification_date": "2021-05-25",
        "status": "A",
        "authorized_official_last_name": "HOLCOMB",
        "authorized_official_first_name": "HOLLY",
        "authorized_official_title_or_position": "CEO",
        "authorized_official_telephone_number": "940-937-6371"
    },
    "taxonomies": [
        {
            "code": "314000000X",
            "taxonomy_group": "",
            "desc": "Skilled Nursing Facility",
            "state": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "001015195",
            "state": "TX"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Villa Haven Health and Rehabililitation Center",
            "code": "3",
            "type": "Doing Business As"
        },
        {
            "organization_name": "Villa Haven Health and Rehabililitation Center",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Breckenridge, TX

Sources for this page

Verify at the official NPI Registry.