NPIMap

Organization Active NPI

Liberty County Hospital District No. 1

Doing business as Colonial Pines Healthcare Center

  • Skilled Nursing Facility
  • San Augustine, TX
National Provider Identifier
1962496836
Registry record updated Dec 5, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Skilled Nursing FacilityTaxonomy code 314000000X
License
116419 Issued in TX
Legal business name
LIBERTY COUNTY HOSPITAL DISTRICT NO. 1
Doing business as
Colonial Pines Healthcare Center
Practice address
1203 FM 1277
San Augustine, TX 75972-1635
Phone
(936) 275-3412
Fax
(936) 275-5394
NPI assigned
Sep 7, 2005
Last updated
Dec 5, 2022By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Dec 5, 2022

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

Authorized official

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Skilled Nursing Facility 314000000X 116419 TX Primary

Addresses

Primary practice location

1203 FM 1277
San Augustine, TX 75972-1635

Mailing address

1500 Waters Ridge Dr
Suite 200
Lewisville, TX 75057-6011
Phone (972) 899-4152

Other identifiers 2

IdentifierTypeStateIssuer
148994001OtherTXMEDICAID CO B
001003341MedicaidTX

Other names 1

  • Colonial Pines Healthcare Center Doing business as

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20170518000995 TX Part A Provider - Skilled Nursing Facility 3678766227 Practice locations: San Augustine, TX

NPI to CCN mapping 1

The Medicare certification numbers (CCNs) connected to NPI 1962496836. Details of each certification follow.

Skilled nursing facility certification: CCN 675358

Legal name
LIBERTY COUNTY HOSPITAL DISTRICT NO 1
Doing business as
COLONIAL PINES HEALTHCARE CENTER
Certification status
Active
Provider type (POS)
Nursing home – SNF/NF distinct part
Participating since
Aug 1, 1994
Last certification
Oct 29, 2024
Beds
107
Ownership / control type
Limited Liability Corporation
Organization structure
GovernmentNon-profit
Enrollment address
1203 FM 1277
San Augustine, TX 75972-1635
Nursing home name
COLONIAL PINES HEALTHCARE CENTER
Affiliated entity
STONEGATE SENIOR LIVING

Care Compare: Nursing home

Medicare Care Compare
Listed as
Colonial Pines Healthcare CenterCCN 675358 · All quality measures
Overall star rating
4 of 5
Health inspections
4 of 5
Staffing
4 of 5
Quality measures
4 of 5
Type
Medicare and Medicaid
Ownership
For profit - Limited Liability company
Certified
Aug 1, 1994
Medicare certification status
ActiveFrom the Provider of Services file
Certified beds
10741.5 residents per day on average
Chain
Stonegate Senior Living24 facilities in the chain

Processed by Care Compare on Aug 1, 2026.

Laboratory certificates & supplier records

Derived by NPIMap

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

CLIA laboratory certificates

CLIA numberLaboratoryCertificateExpires
45D0884666Colonial Pines Healthcare Center1203 FM 1277, San Augustine, TX 75972Certificate of waiverApr 6, 2028

National Provider Directory

National Provider Directory
Tax ID family
Ldrmc Professional Services41 organizations share this tax ID, including this one

Other organizations with this tax ID 40

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

View all 40

Locations

1203 FM 1277
San Augustine, TX 75972
Phone (936) 275-3412

Ownership & related parties

All disclosed owners & managing parties 14

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

NameRoleSinceShare
Amber Renee Waller Individual Adp of the SNF Jul 25, 2024
Martus Financial Services, Inc. Organization, Justin, TX Corporation, For-profit Adp of the SNF Dec 31, 2023
PF Colonial SNF Ops, LLC Organization, Lewisville, TX LLC, For-profit Operational/Managerial Control Sep 23, 2021
Adp of the SNF Dec 8, 2025
Charles Bruce Stratton Individual Corporate OfficerPresident May 1, 2005
Liberty County Hospital District No 1 Organization, Liberty, TX 5% Or Greater Direct Ownership Interest Mar 31, 2017 100%
Deepti a Govathoti Individual Adp of the SNF Jan 1, 2023
Lifetime Wellness, LTD. Organization, Tyler, TX Adp of the SNF Sep 23, 2021
Joshua Tousha Individual Operational/Managerial Control Jan 2, 2023
Adp of the SNF Jan 2, 2023
Rehab Pro LP Organization, Tyler, TX Adp of the SNF Sep 23, 2021
Umb Bank National Association Organization, Dallas, TX Financial institution, Owned by another organization or individual 5% Or Greater Mortgage Interest Sep 23, 2021 100%
Sanctuary LTC, LLC Organization, Lewisville, TX LLC, For-profit Adp of the SNF Sep 23, 2021
Stonegate Senior Living, LP Organization, Lewisville, TX Operational/Managerial Control Jun 22, 2022
Adp of the SNF Dec 8, 2025
Pharmerica Drug Systems LLC Organization, Louisville, KY LLC Adp of the SNF Aug 27, 2017
Preservation Freehold Company Organization, Lewisville, TX Corporation, Non-profit Adp of the SNF Sep 23, 2021

Owners & managing parties with NPI records 17

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

View all 17

All facility ownership & control disclosures 37

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

FacilityTypeRoleSince
Liberty Dayton Regional Medical CenterLiberty, TX, CCN 451375 Hospital Operational/Managerial Control Oct 1, 2014
Liberty Dayton Regional Medical CenterLiberty, TX, CCN 45Z375 Hospital Operational/Managerial Control Oct 1, 2014
Cascades at Senior RehabPort Arthur, TX, CCN 675541 Skilled nursing facility 5% Or Greater Direct Ownership Interest (100%) Dec 1, 2014
Jefferson Nursing and Rehabilitation CenterBeaumont, TX, CCN 676218 Skilled nursing facility 5% Or Greater Direct Ownership Interest (100%)
Operational/Managerial Control
Adp of the SNF		 Nov 30, 2014
Jan 1, 2015
Mar 21, 2025
College Street Health Care CenterBeaumont, TX, CCN 675695 Skilled nursing facility 5% Or Greater Direct Ownership Interest (100%) Dec 1, 2014
The Phoenix Post-AcuteTexas City, TX, CCN 675743 Skilled nursing facility 5% Or Greater Direct Ownership Interest (100%) May 1, 2015
Southland Rehabilitation and Healthcare CenterLufkin, TX, CCN 675962 Skilled nursing facility 5% Or Greater Direct Ownership Interest (100%) May 1, 2015
Timberwood Nursing and Rehabilitation CenterLivingston, TX, CCN 455745 Skilled nursing facility 5% Or Greater Direct Ownership Interest (100%) May 1, 2015
Bremond Nursing and Rehabilitation CenterBremond, TX, CCN 675132 Skilled nursing facility 5% Or Greater Direct Ownership Interest (100%) Apr 1, 2017
Pine Grove Nursing CenterCenter, TX, CCN 675230 Skilled nursing facility 5% Or Greater Direct Ownership Interest (100%) Mar 31, 2017
Briarcliff Skilled Nursing FacilityCarthage, TX, CCN 676051 Skilled nursing facility 5% Or Greater Direct Ownership Interest (100%) Mar 31, 2017
Cass Valley Healthcare CenterCenterville, TX, CCN 675065 Skilled nursing facility Operational/Managerial Control (100%) Apr 1, 2017
Harbor Point Skilled NursingTexas City, TX, CCN 675214 Skilled nursing facility 5% Or Greater Direct Ownership Interest (100%) Apr 1, 2017
The Heights of TomballTomball, TX, CCN 676350 Skilled nursing facility 5% Or Greater Direct Ownership Interest (100%) Apr 1, 2017
The Heights of TylerTyler, TX, CCN 676262 Skilled nursing facility 5% Or Greater Direct Ownership Interest (100%) Apr 1, 2017
Avir at North HoustonHouston, TX, CCN 676356 Skilled nursing facility 5% Or Greater Direct Ownership Interest (100%) Apr 1, 2017
East View HealthcareHouston, TX, CCN 676081 Skilled nursing facility 5% Or Greater Direct Ownership Interest (100%) Apr 1, 2017
Mason Creek Transitional Care of KatyKaty, TX, CCN 676194 Skilled nursing facility 5% Or Greater Direct Ownership Interest (100%) Apr 1, 2017
Copperfield Healthcare and RehabilitationHouston, TX, CCN 676230 Skilled nursing facility 5% Or Greater Direct Ownership Interest (100%) Apr 1, 2017
Misty Willow Healthcare and Rehabilitation CenterHouston, TX, CCN 676251 Skilled nursing facility 5% Or Greater Direct Ownership Interest (100%) Apr 1, 2017
Legend Oaks Healthcare and Rehabilitation-Northwest HoustonHouston, TX, CCN 676137 Skilled nursing facility 5% Or Greater Direct Ownership Interest (100%) Apr 1, 2017
Avalon Place KirbyvilleKirbyville, TX, CCN 675220 Skilled nursing facility 5% Or Greater Direct Ownership Interest (100%) Apr 1, 2017
The Courtyards at PasadenaPasadena, TX, CCN 676155 Skilled nursing facility 5% Or Greater Direct Ownership Interest (100%) Apr 1, 2017
Bridgecrest Rehabilitation SuitesHouston, TX, CCN 676362 Skilled nursing facility 5% Or Greater Direct Ownership Interest (100%) Apr 1, 2017
River Pointe of Trinity Healthcare and Rehabilitation CenterTrinity, TX, CCN 675900 Skilled nursing facility 5% Or Greater Direct Ownership Interest (100%) Oct 1, 2021
Legacy at Town CreekPalestine, TX, CCN 675998 Skilled nursing facility 5% Or Greater Direct Ownership Interest (100%) Apr 1, 2018
Pasadena Post AcutePasadena, TX, CCN 675365 Skilled nursing facility 5% Or Greater Direct Ownership Interest (100%) Mar 1, 2022
Whisperwood Nursing & Rehabilitation CenterLubbock, TX, CCN 675527 Skilled nursing facility 5% Or Greater Direct Ownership Interest (100%) Apr 1, 2022
Vidor Health & Rehabilitation CenterVidor, TX, CCN 676108 Skilled nursing facility 5% Or Greater Direct Ownership Interest (100%) Jun 1, 2022
Fairfield Nursing & Rehabilitation CenterFairfeild, TX, CCN 676123 Skilled nursing facility 5% Or Greater Direct Ownership Interest (100%) May 1, 2022
Greenbrier Nursing & Rehabilitation Center of TylerTyler, TX, CCN 675267 Skilled nursing facility 5% Or Greater Direct Ownership Interest (100%) Apr 1, 2022
Twin Oaks Health & Rehabilitation CenterJacksonville, TX, CCN 675183 Skilled nursing facility 5% Or Greater Direct Ownership Interest (100%) Apr 1, 2022
Caprock Nursing & RehabilitationBorger, TX, CCN 676341 Skilled nursing facility 5% Or Greater Direct Ownership Interest (100%) Jun 1, 2022
Five Points Nursing and RehabilitationAmarillo, TX, CCN 676455 Skilled nursing facility 5% Or Greater Direct Ownership Interest (100%) May 1, 2022
Pine Tree Lodge Nursing CenterLongview, TX, CCN 675177 Skilled nursing facility 5% Or Greater Direct Ownership Interest (100%) May 1, 2022
Mesa Hills Post AcuteBrownsville, TX, CCN 455423 Skilled nursing facility 5% Or Greater Direct Ownership Interest (100%) Mar 1, 2023
Liberty Dayton Medical ClinicLiberty, TX, CCN 673428 Rural health clinic Operational/Managerial Control May 4, 2015

Facilities with the same owner 59

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

View all 59

Practitioners & affiliated clinicians

Practitioners 8

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 2

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": "1126051200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1670198400000",
    "number": "1962496836",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1500 WATERS RIDGE DR",
            "address_2": "SUITE 200",
            "city": "LEWISVILLE",
            "state": "TX",
            "postal_code": "750576011",
            "telephone_number": "972-899-4152",
            "fax_number": "469-312-3796"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1203 FM 1277",
            "city": "SAN AUGUSTINE",
            "state": "TX",
            "postal_code": "759721635",
            "telephone_number": "936-275-3412",
            "fax_number": "936-275-5394"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "LIBERTY COUNTY HOSPITAL DISTRICT NO. 1",
        "organizational_subpart": "NO",
        "enumeration_date": "2005-09-07",
        "last_updated": "2022-12-05",
        "certification_date": "2022-12-05",
        "status": "A",
        "authorized_official_last_name": "STRATTON",
        "authorized_official_first_name": "C",
        "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": "116419",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MEDICAID CO B",
            "identifier": "148994001",
            "state": "TX"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "001003341",
            "state": "TX"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Colonial Pines Healthcare Center",
            "code": "3",
            "type": "Doing Business As"
        },
        {
            "organization_name": "Colonial Pines Healthcare Center",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in San Augustine, TX

Sources for this page

Verify at the official NPI Registry.