Organization
STRATFORD HOUSE, LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DOUG MITTLEIDER (PRESIDENT OF MANAGING MEMBER)
(470) 282-3271
Entity
Organization
Contact information
Practice address
8249 STANDIFER GAP RD, CHATTANOOGA, TN 37421-5046
(470) 282-3271
Mailing address
3050 ROYAL BLVD S, STE. 190, ALPHARETTA, GA 30022-4427
Taxonomy
Speciality
Code
Description
License number
State
314000000X
Skilled Nursing Facility
Primary
APPLIED FOR
TN
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
Q027352
—
TN
05
—
Q027353
—
TN
Enumeration date
01/17/2017
Last updated
06/05/2020
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