Provider Demographics
NPI:1063509248
Name:STRATFORD HOSPITAL DISTRICT
Entity Type:Organization
Organization Name:STRATFORD HOSPITAL DISTRICT
Other - Org Name:HILLSIDE HEIGHTS REHABILITATION SUITES
Other - Org Type:Doing Business As
Authorized Official - Title/Position:CEO
Authorized Official - Prefix:
Authorized Official - First Name:LAURA
Authorized Official - Middle Name:
Authorized Official - Last Name:DAVIS
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:806-396-2844
Mailing Address - Street 1:1111 BEAVER ROAD
Mailing Address - Street 2:
Mailing Address - City:STRATFORD
Mailing Address - State:TX
Mailing Address - Zip Code:79084
Mailing Address - Country:US
Mailing Address - Phone:806-396-2844
Mailing Address - Fax:
Practice Address - Street 1:6650 S SONCY RD
Practice Address - Street 2:
Practice Address - City:AMARILLO
Practice Address - State:TX
Practice Address - Zip Code:79119-6655
Practice Address - Country:US
Practice Address - Phone:806-457-6700
Practice Address - Fax:806-457-6705
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-10-07
Last Update Date:2014-11-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes314000000XNursing & Custodial Care FacilitiesSkilled Nursing Facility
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX001014082Medicaid
675498Medicare Oscar/Certification