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General NPI Number Information
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NPI Number | 1871780924
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Entity Type | Organization
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Legal Business Name | STRATEGIC CARE OF STEPHENVILLE, LLC
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Dates
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Enumeration Date | 10/02/2007
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Last Update Date | 01/27/2009
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Provider Practice Location Address
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Address Line | 2309 W WASHINGTON STREET
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City | STEPHENVILLE
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State | TX
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Zip | 76401-3805
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Country | US
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Telephone | 254-968-4191
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Fax | 254-968-0862
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Provider Business Mailing Address
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Address Line | 2309 W WASHINGTON STREET
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City | STEPHENVILLE
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State | TX
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Zip | 76401-3805
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Country | US
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Telephone | 254-968-4191
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Fax | 254-968-0862
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Authorized Official
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Title or Position | PRESIDENT
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Name | KAYLA SLATER
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Credential | RN, CWOCN
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Telephone | 817-808-7012
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 314000000X
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Taxonomy Name | Skilled Nursing Facility
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License Number | 005085
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License Number State | TX
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Taxonomy #2
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Taxonomy Code | 314000000X
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Taxonomy Name | Skilled Nursing Facility
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License Number | 122400
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License Number State | TX
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