Organization
LUFKIN II ENTERPRISES, LLC
Active
Other names
Lufkin Skilled Care
Organization subpart
No
Provider details
NPI number
Authorized official
GARY BLAKE (MANAGING MEMBER)
(817) 348-8841
Entity
Organization
Contact information
Practice address
504 N JOHN REDDITT DR, LUFKIN, TX 75904-2644
(936) 632-3331
(936) 634-1611
Mailing address
504 N JOHN REDDITT DR, LUFKIN, TX 75904-2644
(936) 632-3331
(936) 634-1611
Taxonomy
Speciality
Code
Description
License number
State
314000000X
Skilled Nursing Facility
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
001026162
—
TX
01
—
004771
FACILITY ID
TX
Enumeration date
08/28/2014
Last updated
02/25/2015
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