# TEAKWOOD MANOR, LLC

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- **Entity:** Organization
- **Status:** Active
- **Organization subpart:** No

## Provider details

- **NPI number:** 1154362887
- **Authorized official:** MR. LEE F. SMITH (PRESIDENT)
- **Authorized official phone:** (940) 692-8977

## Contact information

- **Practice address:** 1003 COLUMBIA ST, STAMFORD, TX 79553-6825
- **Practice address phone:** (325) 773-3671
- **Practice address fax:** (325) 773-5751
- **Mailing address:** 4723 TAFT BLVD, WICHITA FALLS, TX 76308-5001
- **Mailing address phone:** (940) 692-8977
- **Mailing address fax:** (940) 692-8567

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 314000000X | Skilled Nursing Facility | 117297 | TX | Yes |

## Other

- **Enumeration date:** 06/10/2006
- **Last updated:** 08/22/2020

## Other identifiers

| Code | Description | Identifier | Issuer | State |
| --- | --- | --- | --- | --- |
| 01 | — | 4930 | VENDOR NUMBER | TX |