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Organization
WORTHAM I ENTERPRISES, LLC
Active
Organization
WORTHAM I ENTERPRISES, LLC
Active
Other names
Wortham Rehabilitation Center
Organization subpart
No
Provider details
NPI number
Authorized official
GARY BLAKE (MANAGING MEMBER)
(817) 832-3654
Entity
Organization
Contact information
Practice address
117 TWIN CIRCLE, WORTHAM, TX 76693-4611
(254) 765-3377
(254) 765-3858
Mailing address
117 TWIN CIRCLE, WORTHAM, TX 76693-4611
(254) 765-3377
(254) 765-3858
Taxonomy
Speciality
Code
Description
License number
State
314000000X
Skilled Nursing Facility
Primary
—
TX
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
001014624
—
TX
01
—
004987
DADS VENDOR
TX
05
—
183934201
—
TX
Enumeration date
10/23/2006
Last updated
02/06/2015
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