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Organization
GROVETON I ENTERPRISES LLC
Active
Organization
GROVETON I ENTERPRISES LLC
Active
Other names
Groveton Nursing Home
Organization subpart
No
Provider details
NPI number
Authorized official
GARY BLAKE (MANAGING MEMBER)
(817) 348-8959
Entity
Organization
Contact information
Practice address
1020 W 1ST ST, GROVETON, TX 75845-4186
(936) 642-1221
(936) 642-2727
Mailing address
1020 W 1ST ST, GROVETON, TX 75845-4186
(936) 642-1221
(936) 642-2727
Taxonomy
Speciality
Code
Description
License number
State
314000000X
Skilled Nursing Facility
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
001016370
—
TX
01
—
004778
STATE VENDOR
TX
Enumeration date
09/29/2008
Last updated
08/30/2021
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