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Organization
BEAUMONT I ENTERPRISES, LLC
Active
Organization
BEAUMONT I ENTERPRISES, LLC
Active
Other names
Beaumont Nursing and Rehabilitation
Organization subpart
No
Provider details
NPI number
Authorized official
MR. GARY BLAKE (MANAGING MEMBER)
(817) 348-8959
Entity
Organization
Contact information
Practice address
1175 DENTON ST, BEAUMONT, TX 77707-3913
(409) 842-3120
(409) 842-9013
Mailing address
1175 DENTON ST, BEAUMONT, TX 77707-3913
(409) 842-3120
(409) 842-9013
Taxonomy
Speciality
Code
Description
License number
State
314000000X
Skilled Nursing Facility
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
001019897
—
TX
01
—
004786
FACILITY ID
TX
Enumeration date
08/29/2011
Last updated
08/30/2021
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