Organization
STRATFORD HEALTH CARE GROUP, INC
Active
Other names
Hidden Lake Care Center
Organization subpart
No
Provider details
NPI number
Authorized official
RAE A LETTERMAN (ADMINISTRATOR)
(816) 595-1834
Entity
Organization
Contact information
Practice address
11400 HIDDEN LAKE DR, RAYTOWN, MO 64133-7409
(816) 737-1010
(816) 737-0359
Mailing address
PO BOX 16567, RAYTOWN, MO 64133-0567
(816) 737-1010
(816) 595-1861
Taxonomy
Speciality
Code
Description
License number
State
310400000X
Assisted Living Facility
031364
MO
313M00000X
Nursing Facility/Intermediate Care Facility
032518
MO
314000000X
Skilled Nursing Facility
Primary
032518
MO
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
103256202
—
MO
01
—
263256208
PERSONAL CARE NUMBER
MO
Enumeration date
11/01/2006
Last updated
11/10/2011
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