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Organization

MEXIA I ENTERPRISES, LLC

Active
Other names
Mexia Nursing Home
Organization subpart
No

Provider details

NPI number
Authorized official
GARY BLAKE (MANAGING MEMBER)
(817) 348-8841
Entity
Organization

Contact information

Practice address
501 E SUMPTER ST, MEXIA, TX 76667-2354
(254) 562-5542
(254) 562-2206
Mailing address
501 E SUMPTER ST, MEXIA, TX 76667-2354
(254) 562-5542
(254) 562-2206

Taxonomy

Speciality
Code
Description
License number
State
314000000X
Skilled Nursing Facility
Primary
TX

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
001015684
TX
01
004303
DADS VENDOR
Enumeration date
12/14/2007
Last updated
02/06/2015
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