Nacogdoches Csnhc Enterprises, LLC

Primary specialty

Skilled Nursing FacilityTaxonomy code 314000000X

Legal business name

NACOGDOCHES CSNHC ENTERPRISES, LLC

Practice address

227 Russell Blvd
Nacogdoches, TX 75965-1238

Phone

(936) 564-4596

Fax

(936) 564-6824

NPI assigned

Feb 27, 2008

Organization subpart

No

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name

Gary Blake

Title

Managing Member

Phone

(817) 348-8959

Specialties & licenses 1

Addresses

Other identifiers 2

Other names 1

• Willowbrook Nursing Center Doing business as

Locations

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1204070400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1423180800000",
    "number": "1114196771",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "227 RUSSELL BLVD",
            "city": "NACOGDOCHES",
            "state": "TX",
            "postal_code": "759651238",
            "telephone_number": "936-564-4596",
            "fax_number": "936-564-6824"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "227 RUSSELL BLVD",
            "city": "NACOGDOCHES",
            "state": "TX",
            "postal_code": "759651238",
            "telephone_number": "936-564-4596",
            "fax_number": "936-564-6824"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "NACOGDOCHES CSNHC ENTERPRISES, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2008-02-27",
        "last_updated": "2015-02-06",
        "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": "314000000X",
            "taxonomy_group": "",
            "desc": "Skilled Nursing Facility",
            "state": "TX",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "VENDOR STATE",
            "identifier": "005225",
            "state": "TX"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "001015998",
            "state": "TX"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Willowbrook Nursing Center",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

• Nacogdoches County Hospital District
• Nacogdoches County Hospital District
• Nacogdoches County Hospital District
• Nacogdoches County Hospital District
• Nacogdoches County Hospital District
• Nacogdoches Dental Group PLLC
• Nacogdoches Dental PLLC
• Nacogdoches Dialysis Center LP
• Nacogdoches Dialysis Center LP
• Nacogdoches Emergency Medicine Associates PA

• Skilled Nursing Facility in Nacogdoches, TX
• Providers in Nacogdoches, TX by specialty
• Skilled Nursing Facility in Texas

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 6, 2015; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.