Organization
TEAKWOOD MANOR, LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MR. LEE F. SMITH (PRESIDENT)
(940) 692-8977
Entity
Organization
Contact information
Practice address
1003 COLUMBIA ST, STAMFORD, TX 79553-6825
(325) 773-3671
(325) 773-5751
Mailing address
4723 TAFT BLVD, WICHITA FALLS, TX 76308-5001
(940) 692-8977
(940) 692-8567
Taxonomy
Speciality
Code
Description
License number
State
314000000X
Skilled Nursing Facility
Primary
117297
TX
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
4930
VENDOR NUMBER
TX
Enumeration date
06/10/2006
Last updated
08/22/2020
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