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Organization
LUBBOCK III ENTERPRISES, LLC
Active
Organization
LUBBOCK III ENTERPRISES, LLC
Active
Other names
Lubbock Health Care Center
Organization subpart
No
Provider details
NPI number
Authorized official
MR. GARY BLAKE (MANAGING MEMBER)
(817) 348-8959
Entity
Organization
Contact information
Practice address
4120 22ND PL, LUBBOCK, TX 79410-1122
(806) 793-3252
(806) 791-5364
Mailing address
4120 22ND PL, LUBBOCK, TX 79410-1122
(806) 793-3252
(806) 791-5364
Taxonomy
Speciality
Code
Description
License number
State
314000000X
Skilled Nursing Facility
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
001025706
—
TX
01
—
005138
DADS FACILITY ID
TX
Enumeration date
12/16/2013
Last updated
08/30/2021
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