Organization
GLEN ROSE I ENTERPRISES, LLC
Active
Other names
Cherokee Rose Nursing and Rehabilitation
Organization subpart
No
Provider details
NPI number
Authorized official
GARY BLAKE (MANAGING MEMBER)
(817) 348-8959
Entity
Organization
Contact information
Practice address
203 GIBBS BLVD, GLEN ROSE, TX 76043-4309
(254) 897-7361
(254) 897-3970
Mailing address
203 GIBBS BLVD, GLEN ROSE, TX 76043-4309
(254) 897-7361
(254) 897-3970
Taxonomy
Speciality
Code
Description
License number
State
314000000X
Skilled Nursing Facility
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
001019945
—
TX
01
—
005306
FACILITY ID
TX
Enumeration date
09/20/2011
Last updated
08/30/2021
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