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Organization

AMARILLO VI ENTERPRISES, LLC

Active
Other names
Georgia Manor Nursing Home
Organization subpart
No

Provider details

NPI number
Authorized official
GARY BLAKE (MANAGING MEMBER)
(817) 348-8959
Entity
Organization

Contact information

Practice address
2611 SW 46TH AVE, AMARILLO, TX 79110-1735
(806) 355-6517
(806) 355-4190
Mailing address
2611 SW 46TH AVE, AMARILLO, TX 79110-1735
(806) 355-6517
(806) 355-4190

Taxonomy

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

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
001014027
TX
01
004604
VENDOR
Enumeration date
12/18/2008
Last updated
08/30/2021
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