# MEXIA I ENTERPRISES, LLC

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- **Entity:** Organization
- **Status:** Active
- **Other names:** Mexia Nursing Home
- **Organization subpart:** No

## Provider details

- **NPI number:** 1245413046
- **Authorized official:** GARY BLAKE (MANAGING MEMBER)
- **Authorized official phone:** (817) 348-8841

## Contact information

- **Practice address:** 501 E SUMPTER ST, MEXIA, TX 76667-2354
- **Practice address phone:** (254) 562-5542
- **Practice address fax:** (254) 562-2206
- **Mailing address:** 501 E SUMPTER ST, MEXIA, TX 76667-2354
- **Mailing address phone:** (254) 562-5542
- **Mailing address fax:** (254) 562-2206

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 314000000X | Skilled Nursing Facility | — | TX | Yes |

## Other

- **Enumeration date:** 12/14/2007
- **Last updated:** 02/06/2015

## Other identifiers

| Code | Description | Identifier | Issuer | State |
| --- | --- | --- | --- | --- |
| 05 | — | 001015684 | — | TX |
| 01 | — | 004303 | DADS VENDOR | — |