# THROCKMORTON I ENTERPRISES, LLC

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- **Entity:** Organization
- **Status:** Active
- **Other names:** Throckmorton Nursing & Rehabilitation
- **Organization subpart:** No

## Provider details

- **NPI number:** 1437409562
- **Authorized official:** MR. GARY BLAKE (MANAGING MEMBER)
- **Authorized official phone:** (817) 348-8841

## Contact information

- **Practice address:** 1000 N MINTER AVE, THROCKMORTON, TX 76483-4900
- **Practice address phone:** (940) 849-2861
- **Practice address fax:** (940) 849-6011
- **Mailing address:** 1000 N MINTER AVE, THROCKMORTON, TX 76483-4900
- **Mailing address phone:** (940) 849-2861
- **Mailing address fax:** (940) 849-6011

## Taxonomy

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

## Other

- **Enumeration date:** 09/17/2012
- **Last updated:** 09/17/2012

## Other identifiers

| Code | Description | Identifier | Issuer | State |
| --- | --- | --- | --- | --- |
| 01 | — | 004246 | FACILITY ID | TX |