Organization
KENEDY I ENTERPRISES, LLC
Active
Other names
Kenedy Health & Rehabilitation
Organization subpart
No
Provider details
NPI number
Authorized official
GARY BLAKE (MANAGING MEMBER)
(817) 348-8959
Entity
Organization
Contact information
Practice address
7882 S HWY 181, KENEDY, TX 78119-2729
(830) 583-9101
(830) 583-2962
Mailing address
P.O. DRAWER E, KENEDY, TX 78119-2729
(830) 583-9101
(830) 583-2962
Taxonomy
Speciality
Code
Description
License number
State
314000000X
Skilled Nursing Facility
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
001018522
—
TX
01
—
004449
FACILITY ID
TX
Enumeration date
05/10/2010
Last updated
08/30/2021
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