Alice II Enterprises, LLC

Key facts

NPI

1104416049

Entity type

Organization (NPI type 2)

Primary specialty

Assisted Living Facility 310400000X

Legal business name

ALICE II ENTERPRISES, LLC

Practice address

800-B Coyote Trail
Alice, TX 78332

Phone

(361) 666-3801

NPI assigned

Jan 25, 2021

Organization subpart

No

Authorized official

Name

Gary Blake

Title

Managing Member

Phone

(817) 348-8959

National Provider Directory

Specialties & licenses

Addresses

Other names

• The Premier Memory Care of Alice Doing business as

The complete NPPES record for this NPI in the NPI Registry API JSON format, last updated by the provider on Jan 25, 2021.

{
    "created_epoch": "1611532800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1611532800000",
    "number": "1104416049",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4150 INTERNATIONAL PLZ STE 600",
            "city": "FT WORTH",
            "state": "TX",
            "postal_code": "761094831",
            "telephone_number": "817-348-8959"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "800-B COYOTE TRAIL",
            "city": "ALICE",
            "state": "TX",
            "postal_code": "78332",
            "telephone_number": "361-666-3801"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "ALICE II ENTERPRISES, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2021-01-25",
        "last_updated": "2021-01-25",
        "certification_date": "2021-01-08",
        "status": "A",
        "authorized_official_last_name": "BLAKE",
        "authorized_official_first_name": "GARY",
        "authorized_official_title_or_position": "MANAGING MEMBER",
        "authorized_official_telephone_number": "817-348-8959"
    },
    "taxonomies": [
        {
            "code": "310400000X",
            "taxonomy_group": "",
            "desc": "Assisted Living Facility",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "The Premier Memory Care of Alice",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

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