Provider Demographics
NPI:1386848471
Name:STRATEGIC CARE OF HEREFORD, LLC.
Entity type:Organization
Organization Name:STRATEGIC CARE OF HEREFORD, LLC.
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:PRES/MANAGE
Authorized Official - Prefix:
Authorized Official - First Name:KAYLA
Authorized Official - Middle Name:S
Authorized Official - Last Name:SLATER
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:903-851-2848
Mailing Address - Street 1:231 KINGWOOD STREET
Mailing Address - Street 2:
Mailing Address - City:HEREFORD
Mailing Address - State:TX
Mailing Address - Zip Code:79045-3816
Mailing Address - Country:US
Mailing Address - Phone:806-364-7113
Mailing Address - Fax:806-364-0340
Practice Address - Street 1:231 KINGWOOD STREET
Practice Address - Street 2:
Practice Address - City:HEREFORD
Practice Address - State:TX
Practice Address - Zip Code:79045
Practice Address - Country:US
Practice Address - Phone:806-354-7113
Practice Address - Fax:806-364-7276
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:STRATEGIC MANAGEMENT GROUP LLC.
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2007-06-12
Last Update Date:2009-03-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX125796313M00000X
TX120150314000000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes313M00000XNursing & Custodial Care FacilitiesNursing Facility/Intermediate Care Facility
No314000000XNursing & Custodial Care FacilitiesSkilled Nursing Facility
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX005320Medicaid
675868Medicare Oscar/Certification