Organization
LA DORA MANAGEMENT, INC.
Active
Other names
La Dora Nursing & Rehab Center
Organization subpart
No
Provider details
NPI number
Authorized official
BRYAN CHRISTOPHER STEPHENS LNFA (ADMINISTRATOR)
(817) 283-4771
Entity
Organization
Contact information
Practice address
1960 BEDFORD RD, BEDFORD, TX 76021-5722
(817) 283-4771
(817) 283-4020
Mailing address
1960 BEDFORD RD., BEDFORD, TX 76021-5712
(817) 283-4771
(817) 283-4020
Taxonomy
Speciality
Code
Description
License number
State
314000000X
Skilled Nursing Facility
Primary
116904
TX
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
001004568
—
TX
01
—
165683701
MEDICAID TEXAS PROVIDER IDENTIFIER
TX
Enumeration date
10/25/2006
Last updated
04/27/2010
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