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Organization
MEXIA I ENTERPRISES, LLC
Active
Organization
MEXIA I ENTERPRISES, LLC
Active
Other names
Mexia Nursing Home
Organization subpart
No
Provider details
NPI number
Authorized official
GARY BLAKE (MANAGING MEMBER)
(817) 348-8841
Entity
Organization
Contact information
Practice address
501 E SUMPTER ST, MEXIA, TX 76667-2354
(254) 562-5542
(254) 562-2206
Mailing address
501 E SUMPTER ST, MEXIA, TX 76667-2354
(254) 562-5542
(254) 562-2206
Taxonomy
Speciality
Code
Description
License number
State
314000000X
Skilled Nursing Facility
Primary
—
TX
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
001015684
—
TX
01
—
004303
DADS VENDOR
—
Enumeration date
12/14/2007
Last updated
02/06/2015
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