Organization
STEPHENVILLE I ENTERPRISES, LLC
Active
Other names
Stephenville Nursing and Rehabilitation
Organization subpart
No
Provider details
NPI number
Authorized official
GARY BLAKE (MANAGING MEMBER)
(817) 348-8841
Entity
Organization
Contact information
Practice address
2311 W WASHINGTON ST, STEPHENVILLE, TX 76401-3805
(254) 968-3313
(254) 968-6890
Mailing address
2311 W WASHINGTON ST, STEPHENVILLE, TX 76401-3805
(254) 968-3313
(254) 968-6890
Taxonomy
Speciality
Code
Description
License number
State
314000000X
Skilled Nursing Facility
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
004051
FACILITY ID
TX
Enumeration date
01/18/2010
Last updated
01/18/2010
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