Provider Demographics
NPI:1699710103
Name:STRATEGIC CARE OF BROWNWOOD LLC.
Entity type:Organization
Organization Name:STRATEGIC CARE OF BROWNWOOD 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:817-723-2095
Mailing Address - Street 1:200 COUNTY ROAD 616
Mailing Address - Street 2:
Mailing Address - City:BROWNWOOD
Mailing Address - State:TX
Mailing Address - Zip Code:76802-3294
Mailing Address - Country:US
Mailing Address - Phone:325-646-5521
Mailing Address - Fax:325-643-2790
Practice Address - Street 1:200 COUNTY ROAD 616
Practice Address - Street 2:
Practice Address - City:BROWNWOOD
Practice Address - State:TX
Practice Address - Zip Code:76802-3294
Practice Address - Country:US
Practice Address - Phone:325-646-5521
Practice Address - Fax:325-643-2790
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:STRATEGIC MANAGEMENT GROUP LLC.
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2006-06-18
Last Update Date:2009-03-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX120480313M00000X
TX116769314000000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes313M00000XNursing & Custodial Care FacilitiesNursing Facility/Intermediate Care Facility
No314000000XNursing & Custodial Care FacilitiesSkilled Nursing Facility
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX001014056Medicaid
TX004124Medicaid
TX004124Medicaid