# STRATFORD HOSPITAL DISTRICT DBA COLDWATER MANOR

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

## Provider details

- **NPI number:** 1558491506
- **Authorized official:** MR. MARK NELSON MOORE LNHFA (ADMINISTRATOR)
- **Authorized official phone:** (806) 396-5568

## Contact information

- **Practice address:** 1111 BEAVER RD., STRATFORD, TX 79084-1189
- **Practice address phone:** (806) 396-5568
- **Practice address fax:** (806) 396-5930
- **Mailing address:** PO BOX 1189, 1111 BEAVER RD., STRATFORD, TX 79084-1189
- **Mailing address phone:** (806) 396-5568
- **Mailing address fax:** (806) 396-5930

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 313M00000X | Nursing Facility/Intermediate Care Facility | 005110 | TX | Yes |

## Other

- **Enumeration date:** 03/07/2007
- **Last updated:** 02/11/2015

## Other identifiers

| Code | Description | Identifier | Issuer | State |
| --- | --- | --- | --- | --- |
| 05 | — | 000511001 | — | TX |