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Organization
GOLDTHWAITE I ENTERPRISES, LLC
Active
Organization
GOLDTHWAITE I ENTERPRISES, LLC
Active
Other names
Goldthwaite Health & Rehabilitation Center
Organization subpart
No
Provider details
NPI number
Authorized official
GARY BLAKE (MANAGING MEMBER)
(817) 348-8841
Entity
Organization
Contact information
Practice address
1207 REYNOLDS ST, GOLDTHWAITE, TX 76844-2475
(325) 648-2258
(325) 648-3496
Mailing address
1207 REYNOLDS ST, GOLDTHWAITE, TX 76844-2475
(325) 648-2258
(325) 648-3496
Taxonomy
Speciality
Code
Description
License number
State
314000000X
Skilled Nursing Facility
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
001017724
—
TX
01
—
004411
STATE LICENSE
TX
Enumeration date
08/26/2009
Last updated
02/25/2015
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