Stratford House, LLC

Primary specialty

Skilled Nursing FacilityTaxonomy code 314000000X

License

APPLIED FOR Issued in TN

Legal business name

STRATFORD HOUSE, LLC

Practice address

8249 Standifer Gap Rd
Chattanooga, TN 37421-5046

Phone

(470) 282-3271

NPI assigned

Jan 17, 2017

Organization subpart

No

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name

Doug Mittleider

Title

President of Managing Member

Phone

(470) 282-3271

Specialties & licenses 1

Addresses

Other identifiers 2

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1484611200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1591315200000",
    "number": "1063958841",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3050 ROYAL BLVD S",
            "address_2": "STE. 190",
            "city": "ALPHARETTA",
            "state": "GA",
            "postal_code": "300224427"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "8249 STANDIFER GAP RD",
            "city": "CHATTANOOGA",
            "state": "TN",
            "postal_code": "374215046",
            "telephone_number": "470-282-3271"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "STRATFORD HOUSE, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2017-01-17",
        "last_updated": "2020-06-05",
        "certification_date": "2020-06-05",
        "status": "A",
        "authorized_official_last_name": "MITTLEIDER",
        "authorized_official_first_name": "DOUG",
        "authorized_official_title_or_position": "PRESIDENT OF MANAGING MEMBER",
        "authorized_official_telephone_number": "470-282-3271"
    },
    "taxonomies": [
        {
            "code": "314000000X",
            "taxonomy_group": "",
            "desc": "Skilled Nursing Facility",
            "state": "TN",
            "license": "APPLIED FOR",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "Q027352",
            "state": "TN"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "Q027353",
            "state": "TN"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Devonne Elizabeth Stowers, LCMHC
• Timothy Alexander Strait, M.D.
• Kristin Leshay Strange, NP-C
• Strategies for Life of Tennessee LLC
• Stratford Facility Operations, LLC
• Alexander A Stratienko, MD
• Anna Straussberger, BCBA
• Ronald Richard Streko, MD
• Dustin Glenn Stricker, DO
• Adrien K Strickland, MD

• Skilled Nursing Facility in Chattanooga, TN
• Providers in Chattanooga, TN by specialty
• Skilled Nursing Facility in Tennessee

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 5, 2020; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.