Organization
EAGLE PASS I ENTERPRISES, LLC
Active
Other names
Eagle Pass 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
2550 ZACATECAS DR, EAGLE PASS, TX 78852-4129
(830) 773-4488
(830) 773-9681
Mailing address
2550 ZACATECAS DR, EAGLE PASS, TX 78852-4129
(830) 773-4488
(830) 773-9681
Taxonomy
Speciality
Code
Description
License number
State
314000000X
Skilled Nursing Facility
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
001020253
—
TX
01
—
005009
FACILITY ID
TX
Enumeration date
01/24/2012
Last updated
08/30/2021
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