Robert W. Leiske Legacy Centers, Inc.

Primary specialty

Assisted Living FacilityTaxonomy code 310400000X

License

103976 Issued in NU

Legal business name

ROBERT W. LEISKE LEGACY CENTERS, INC.

Doing business as

Country Club Retirement Community

Practice address

4773 FM 933 N
Whitney, TX 76692-4713

Phone

(214) 328-9828

Fax

(214) 328-3042

NPI assigned

Jul 12, 2018

Last updated

Oct 7, 2026By the provider in NPPES

Organization subpart

No

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

Authorized official

Name

Barbara Ecord

Title

Vice President

Phone

(214) 328-9828

Specialties & licenses 1

Addresses

Other identifiers 1

Other names 1

• Country Club Retirement Community Doing business as

Electronic endpoints 1

Locations

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

{
    "created_epoch": "1531353600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1791331200000",
    "number": "1821574856",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "745 N BUCKNER BLVD",
            "city": "DALLAS",
            "state": "TX",
            "postal_code": "752182786",
            "telephone_number": "214-328-9828",
            "fax_number": "214-328-9828"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4773 FM 933 N",
            "city": "WHITNEY",
            "state": "TX",
            "postal_code": "766924713",
            "telephone_number": "214-328-9828",
            "fax_number": "214-328-3042"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "ROBERT W. LEISKE LEGACY CENTERS, INC.",
        "organizational_subpart": "NO",
        "enumeration_date": "2018-07-12",
        "last_updated": "2026-10-07",
        "certification_date": "2026-10-07",
        "status": "A",
        "authorized_official_last_name": "ECORD",
        "authorized_official_first_name": "BARBARA",
        "authorized_official_title_or_position": "VICE PRESIDENT",
        "authorized_official_telephone_number": "214-328-9828"
    },
    "taxonomies": [
        {
            "code": "310400000X",
            "taxonomy_group": "",
            "desc": "Assisted Living Facility",
            "state": "NU",
            "license": "103976",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "103976",
            "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": "Country Club Retirement Community",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

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• Assisted Living Facility in Whitney, TX
• Providers in Whitney, TX by specialty
• Assisted Living Facility in Texas

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 7, 2026; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.