Provider Demographics
NPI:1659353589
Name:STRATFORD HOSPITAL DISTRICT
Entity Type:Organization
Organization Name:STRATFORD HOSPITAL DISTRICT
Other - Org Name:LUBBOCK HOSPITALITY NURSING AND REHABILITATION CENTER
Other - Org Type:Doing Business As
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:RICHARD
Authorized Official - Middle Name:
Authorized Official - Last Name:CHUMLEY
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:806-396-5568
Mailing Address - Street 1:4710 SLIDE RD
Mailing Address - Street 2:
Mailing Address - City:LUBBOCK
Mailing Address - State:TX
Mailing Address - Zip Code:79414-3404
Mailing Address - Country:US
Mailing Address - Phone:806-797-3481
Mailing Address - Fax:806-796-1755
Practice Address - Street 1:4710 SLIDE RD
Practice Address - Street 2:
Practice Address - City:LUBBOCK
Practice Address - State:TX
Practice Address - Zip Code:79414-3404
Practice Address - Country:US
Practice Address - Phone:806-797-3481
Practice Address - Fax:806-796-1755
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2005-11-16
Last Update Date:2020-04-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX139836314000000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes314000000XNursing & Custodial Care FacilitiesSkilled Nursing Facility
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX001013933Medicaid
TX001013933Medicaid
TX455940Medicare Oscar/Certification