Organization
TEAGUE I ENTERPRISES, LLC
Active
Other names
Teague Nursing Home
Organization subpart
No
Provider details
NPI number
Authorized official
GARY BLAKE (MANAGING MEMBER)
(817) 348-8959
Entity
Organization
Contact information
Practice address
884 US HWY 84 W, TEAGUE, TX 75860-5142
(254) 739-2541
(254) 739-5233
Mailing address
884 US HWY 84 W, TEAGUE, TX 75860-5142
(254) 739-2541
(254) 739-5233
Taxonomy
Speciality
Code
Description
License number
State
314000000X
Skilled Nursing Facility
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
5013
—
TX
Enumeration date
01/23/2007
Last updated
10/31/2007
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