Organization
DEL RIO I ENTERPRISES, LLC
Active
Other names
La Vida Serena 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
711 KINGS WAY, DEL RIO, TX 78840-2029
(830) 774-0698
(830) 774-0959
Mailing address
711 KINGS WAY, DEL RIO, TX 78840-2029
(830) 774-0698
(830) 774-0959
Taxonomy
Speciality
Code
Description
License number
State
314000000X
Skilled Nursing Facility
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
001020257
—
TX
01
—
005286
FACILITY ID
TX
Enumeration date
01/24/2012
Last updated
08/30/2021
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