Citizens Medical Center County of Victoria
Organization Active NPI Skilled Nursing Facility · Edna, TX
NPI 1801217997 · NPPES record last updated May 13, 2026
Key facts
- NPI
- 1801217997
- Entity type
- Organization (NPI type 2)
- Primary specialty
- Skilled Nursing Facility 314000000X
- Legal business name
- CITIZENS MEDICAL CENTER COUNTY OF VICTORIA
- Practice address
- 1401 W Main St
Edna, TX 77957-2454 - Phone
- (361) 782-7614
- Fax
- (833) 217-5345
- NPI assigned
- Dec 17, 2013
- Organization subpart
- No
Authorized official
- Name
- Mr. Michael Olson
- Title
- Ceo/Administrator
- Phone
- (361) 573-9181
Owners & managing parties with NPI records 8
-
Fariborz Gorouhi, M.D.
Owned or controlled facilities with NPI records 5
Other NPIs with the same Medicare PAC ID 6
Corporate family (same tax ID) 11
Facilities with the same owner 54
Practitioners 4
-
Cesar Alfredo Maldonado, M.D.
-
Timothy R McFarland, M.D.
Affiliated clinicians 2
Medicare Care Compare: Nursing home
- Listed as
- Southbrooke Manor Nursing and Rehabilitation Cente
- Overall star rating
- ★★★★☆ 4 of 5
- Health inspections
- ★★★★☆ 4 of 5
- Staffing
- ★★☆☆☆ 2 of 5
- Quality measures
- ★★★☆☆ 3 of 5
- Type
- Medicare and Medicaid
- Ownership
- Non profit - Corporation
- Certified
- Jul 1, 1993
- Medicare certification status
- Active
- Certified beds
- 120 · 84.3 residents per day on average
- Chain
- Wellsential Health
Medicare participation
- Medicare fee-for-service enrollment
- Enrolled in TX
Skilled nursing facility certification: CCN 675159
- Legal name
- CITIZENS MEDICAL CENTER COUNTY OF VICTORIA
- Doing business as
- SOUTHBROOKE MANOR NURSING AND REHABILITATION CENTER
- Certification status
- Active
- Provider type (POS)
- Nursing home – SNF/NF distinct part
- Participating since
- Jul 1, 1993
- Last certification
- Nov 22, 2024
- Beds
- 120
- Ownership / control type
- Nonprofit Corporation
- Multi-facility organization
- Regency Integrated Health Services
- Organization structure
- Other · Non-profit
- Incorporated
- in TX
- Enrollment address
- 1401 W Main St
Edna, TX 77957-2454 - Nursing home name
- SOUTHBROOKE MANOR NURSING AND REHABILITATION CENTER
- Affiliated entity
- WELLSENTIAL HEALTH
All disclosed owners & managing parties 36
| Name | Role | Since | Share |
|---|---|---|---|
| CSV Rhea Management Holdco, LLC |
Indirect Ownership Interest | Mar 1, 2014 | |
| Russell Marshall |
Managing Control - Governing Body |
Apr 23, 2014 | |
| Ben Galvin |
Managing Control - Governing Body |
Jun 16, 2014 | |
| |
Adp of the SNF | Jan 1, 2025 | |
| Michael R Olson |
Corporate Officer |
Nov 12, 2015 | |
| Managing Control - Governing Body |
Nov 12, 2015 | ||
| Molly Breanne Quinn-Frankel |
Adp of the SNF | Jan 1, 2025 | |
| Regency IHS Rehab LLC |
Adp of the SNF | Mar 1, 2014 | |
| Regency Texas Holdings LLC |
Indirect Ownership Interest | Mar 1, 2014 | |
| Luis a Guerra |
Managing Control - Governing Body |
Jan 1, 2009 | |
| Courtney Korenek |
Operational/Managerial Control | Aug 8, 2023 | |
| Adp of the SNF | Aug 8, 2023 | ||
| Patricia Gibson |
Managing Control - Governing Body |
Aug 1, 2021 | |
| Jack and Nancy Dwyer Workforce Development Center Inc |
Indirect Ownership Interest | Mar 1, 2014 | |
| Reg Operator Holdco LLC |
Indirect Ownership Interest | Mar 1, 2014 | |
| Barbara B Clapp |
Managing Control - Governing Body |
Jun 1, 2021 | |
| |
Adp of the SNF | Jan 1, 2025 | |
| Reg HG Opco LLC |
Indirect Ownership Interest | Mar 1, 2014 | |
| Antonio Carvajal |
Managing Control - Governing Body |
May 16, 2024 | |
| |
Adp of the SNF | Jan 1, 2025 | |
| Reg HG Opco 1, LLC |
Indirect Ownership Interest | Mar 1, 2014 | |
| Paul B Holm |
Managing Control - Governing Body |
Jan 1, 2007 | |
| Regency IHS Master Tenant LLC |
Adp of the SNF | Mar 1, 2014 | |
| DWD TX Holdings LLC |
Indirect Ownership Interest | Mar 1, 2014 | |
| Veronica Gonzales |
Managing Control - Governing Body |
May 16, 2024 | |
| Regency Integrated Health Services LLC |
Operational/Managerial Control | Mar 1, 2014 | |
| Adp of the SNF | Mar 27, 2025 | ||
| Nicole Kaufman |
Managing Control - Governing Body |
Aug 10, 2021 | |
| Regency IHS of Southbrooke Manor LLC |
Operational/Managerial Control | Mar 1, 2014 | 100% |
| Adp of the SNF | Mar 27, 2025 | ||
| Direct Ownership Interest | Mar 1, 2014 | ||
| Daniel S Baird |
Managing Control - Governing Body |
Apr 13, 2021 | |
| Fariborz Gorouhi |
Managing Control - Governing Body |
Jul 1, 2023 | |
| 1401 West Main Street LLC |
Adp of the SNF | Mar 1, 2014 | |
| Regency IHS Clinical Consulting, LLC |
Adp of the SNF | Mar 1, 2014 | |
| James F Neumann |
Managing Control - Governing Body |
May 31, 2016 | |
| Ashlie Ann Thomas |
Managing Control - Governing Body |
Jul 1, 2023 | |
| Donovan R Dekowski |
Operational/Managerial Control | Mar 1, 2014 | |
| Adp of the SNF | Mar 1, 2014 | ||
| Daren a Cortese |
Managing Control - Governing Body |
Aug 10, 2021 | |
| Citizens Medical Center County of Victoria |
5% Or Greater Direct Ownership Interest | Mar 1, 2014 | 100% |
| Operational/Managerial Control | Mar 1, 2014 | 100% | |
| Adp of the SNF | Mar 27, 2025 | ||
| Elliot J Mandelbaum |
Managing Control - Governing Body |
Jan 1, 2025 |
All facility ownership & control disclosures 5
| Facility | Type | Role | Since |
|---|---|---|---|
| Citizens Medical Center |
Hospital | 5% Or Greater Direct Ownership Interest | Jul 1, 1966 |
| Stevens Nursing and Rehabilitation Center of Hallettsville |
Skilled nursing facility | 5% Or Greater Direct Ownership Interest (100%) Operational/Managerial Control (100%) Adp of the SNF |
Mar 1, 2014 Mar 1, 2014 Mar 1, 2014 |
| Wharton Nursing and Rehabilitation Center |
Skilled nursing facility | 5% Or Greater Direct Ownership Interest (100%) Operational/Managerial Control Adp of the SNF |
Mar 1, 2014 Mar 1, 2014 Mar 28, 2025 |
| Port Lavaca Nursing and Rehabilitation Center |
Skilled nursing facility | 5% Or Greater Direct Ownership Interest (100%) Operational/Managerial Control (100%) Adp of the SNF |
Mar 1, 2014 Mar 1, 2014 Mar 27, 2025 |
| Cuero Nursing and Rehabilitation Center |
Skilled nursing facility | 5% Or Greater Direct Ownership Interest (100%) Operational/Managerial Control (100%) Adp of the SNF |
Mar 1, 2014 Mar 1, 2014 Mar 26, 2025 |
Medicare enrollment records
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| O20140410000267 | TX | Part a Provider - Skilled Nursing Facility | 9537139845 | Practice locations: Edna, TX |
National Provider Directory
- Tax ID family
- Citizens Medical Center Co
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Skilled Nursing Facility | 314000000X | Yes |
Addresses
Primary practice location
1401 W Main St
Edna, TX 77957-2454
Mailing address
2701 Hospital Dr
Victoria, TX 77901-5748
Phone (361) 573-9181
Other identifiers
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 361148501 | Medicaid | TX | |
| 001025756 | Medicaid | TX | |
| 5302 | Medicaid | TX |
Other names
- SOUTHBROOKE MANOR NURSING AND REHABILITATION CENTER
Electronic endpoints
| Type | Endpoint | Use | Affiliation |
|---|---|---|---|
| CONNECT URL | https://199.119.81.30:8291/Gateway/DocumentSubmission/2_0/NhinService/XDRResponse_Service | Other | eSolutions Inc |
NPI Registry JSON
{
"created_epoch": "1387238400000",
"enumeration_type": "NPI-2",
"last_updated_epoch": "1778630400000",
"number": "1801217997",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "2701 HOSPITAL DR",
"city": "VICTORIA",
"state": "TX",
"postal_code": "779015748",
"telephone_number": "361-573-9181",
"fax_number": "361-572-5126"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1401 W MAIN ST",
"city": "EDNA",
"state": "TX",
"postal_code": "779572454",
"telephone_number": "361-782-7614",
"fax_number": "833-217-5345"
}
],
"practiceLocations": [],
"basic": {
"organization_name": "CITIZENS MEDICAL CENTER COUNTY OF VICTORIA",
"organizational_subpart": "NO",
"enumeration_date": "2013-12-17",
"last_updated": "2026-05-13",
"certification_date": "2026-05-13",
"status": "A",
"authorized_official_last_name": "OLSON",
"authorized_official_first_name": "MICHAEL",
"authorized_official_title_or_position": "CEO/ADMINISTRATOR",
"authorized_official_telephone_number": "361-573-9181",
"authorized_official_name_prefix": "Mr."
},
"taxonomies": [
{
"code": "314000000X",
"taxonomy_group": "",
"desc": "Skilled Nursing Facility",
"state": null,
"license": null,
"primary": true
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "361148501",
"state": "TX"
},
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "001025756",
"state": "TX"
},
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "5302",
"state": "TX"
}
],
"endpoints": [
{
"endpointType": "CONNECT",
"endpointTypeDescription": "CONNECT URL",
"endpoint": "https://199.119.81.30:8291/Gateway/DocumentSubmission/2_0/NhinService/XDRResponse_Service",
"affiliation": "Y",
"endpointDescription": "2.16.840.1.113883.3.1066.1",
"affiliationName": "eSolutions Inc",
"use": "OTHER",
"useDescription": "Other",
"useOtherDescription": "CMS esMD eMDR",
"contentType": "OTHER",
"contentTypeDescription": "Other",
"contentOtherDescription": "CSV",
"address_1": "8215 W 108th Ter",
"city": "Overland Park",
"state": "KS",
"country_code": "US",
"postal_code": "662101661",
"country_name": "United States",
"address_type": "DOM"
}
],
"other_names": [
{
"organization_name": "SOUTHBROOKE MANOR NURSING AND REHABILITATION CENTER",
"code": "3",
"type": "Doing Business As"
},
{
"organization_name": "SOUTHBROOKE MANOR NURSING AND REHABILITATION CENTER",
"code": "3",
"type": "Doing Business As"
}
]
}Other providers in Edna, TX
- Berkeley Eye Institute, PLLC
- Jominique Brown
- Bruce W Rogers
- Sarah Bubela
- Care Inn of Edna LLC
- City of Edna Volunteer Ambulance Service
- Stephanie Cunningham
- Hiwot Dinkale
- Deke Steven Eberhard
- Edna Dentistry, PLLC
All providers in Edna, TX · Skilled Nursing Facility in Texas
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on May 13, 2026. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- Medicare Fee-For-Service Public Provider Enrollment (CMS/PECOS): enrollments, PAC IDs and benefit reassignments.
- CMS facility enrollments, All Owners and change-of-ownership files: CCNs, owners and managing parties.
- Provider of Services files (CMS): certification status, beds and related CCNs.
- Medicare Care Compare provider data (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.