NPIMap

Organization Active NPI

Lake Worth I Enterprises, L.L.C.

Doing business as Lake Lodge Nursing & Rehabilitation

  • Skilled Nursing Facility
  • Lake Worth, TX
National Provider Identifier
1194324368
Registry record updated Nov 19, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Skilled Nursing FacilityTaxonomy code 314000000X
Legal business name
LAKE WORTH I ENTERPRISES, L.L.C.
Doing business as
Lake Lodge Nursing & Rehabilitation
Practice address
3800 Marina Dr
Lake Worth, TX 76135-2835
Phone
(817) 237-7231
Fax
(817) 237-5086
NPI assigned
Oct 20, 2020
Last updated
Nov 19, 2024By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Nov 19, 2024

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

Authorized official

Name
Linda Huggins
Title
VP of Accounts Receivable
Phone
(817) 348-8959

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Skilled Nursing Facility 314000000X NU Primary

Addresses

Primary practice location

3800 Marina Dr
Lake Worth, TX 76135-2835

Mailing address

4150 International PLZ Ste 600
Fort Worth, TX 76109-4831
Phone (817) 348-8959

Other names 1

  • Lake Lodge Nursing & Rehabilitation Doing business as

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in TX

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20201208000315 TX Part A Provider - Skilled Nursing Facility 8527470079 Practice locations: Lake Worth, TX

NPI to CCN mapping 1

The Medicare certification numbers (CCNs) connected to NPI 1194324368. Details of each certification follow.

Skilled nursing facility certification: CCN 455903

Legal name
LAKE WORTH I ENTERPRISES, LLC
Doing business as
LAKE LODGE NURSING & REHABILITATION
Certification status
Active
Provider type (POS)
Nursing home – SNF/NF distinct part
Participating since
Nov 20, 1990
Last certification
Oct 17, 2024
Beds
140
Ownership / control type
Limited Liability Corporation
Multi-facility organization
Creative Solutions
Organization structure
LLCProprietary
Incorporated
Sep 30, 2020 in TX
Enrollment address
3800 Marina Dr
Lake Worth, TX 76135-2835
Nursing home name
LAKE LODGE NURSING & REHABILITATION
Affiliated entity
CREATIVE SOLUTIONS IN HEALTHCARE

Care Compare: Nursing home

Medicare Care Compare
Listed as
Lake Lodge Nursing & RehabilitationCCN 455903 · All quality measures
Overall star rating
1 of 5
Health inspections
2 of 5
Staffing
1 of 5
Quality measures
3 of 5
Type
Medicare and Medicaid
Ownership
For profit - Limited Liability company
Certified
Nov 20, 1990
Medicare certification status
ActiveFrom the Provider of Services file
Certified beds
14069.8 residents per day on average
Chain
Creative Solutions in Healthcare149 facilities in the chain
Penalties (3 years)
2Fines totaling $33,845

Processed by Care Compare on Aug 1, 2026.

National Provider Directory

National Provider Directory

Ownership & related parties

All disclosed owners & managing parties 5

As disclosed on the Medicare enrollment (CMS All Owners files). Individuals include officers, directors and managing employees, who may not hold ownership.

NameRoleSinceShare
Malisa a Blake Individual 5% Or Greater Indirect Ownership InterestMember Dec 1, 2020 50%
Operational/Managerial ControlMember Dec 1, 2020 50%
Gary R Blake Individual 5% Or Greater Indirect Ownership InterestManaging Member Dec 1, 2020 50%
Operational/Managerial ControlManaging Member Dec 1, 2020 50%
Linda F Huggins Individual W-2 Managing EmployeeVP of Accounts Receivable Dec 1, 2020
Honor X Enterprises, LLC Organization, Fort Worth, TX LLC, For-profit 5% Or Greater Direct Ownership Interest Dec 1, 2020 100%
Creative Solutions in Healthcare Inc Organization, Fort Worth, TX Corporation, Management services company, For-profit Operational/Managerial Control Jan 1, 2021 100%

Facilities with the same owner 45

Facilities that share an organizational owner with 5% or greater ownership or operational control.

View all 45

Practitioners & affiliated clinicians

Practitioners 4

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

Affiliated clinicians 1

Clinicians who list this facility as an affiliation in Medicare Care Compare.

NPI Registry JSON

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

{
    "created_epoch": "1603152000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1731974400000",
    "number": "1194324368",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4150 INTERNATIONAL PLZ STE 600",
            "city": "FORT 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": "3800 MARINA DR",
            "city": "LAKE WORTH",
            "state": "TX",
            "postal_code": "761352835",
            "telephone_number": "817-237-7231",
            "fax_number": "817-237-5086"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "LAKE WORTH I ENTERPRISES, L.L.C.",
        "organizational_subpart": "NO",
        "enumeration_date": "2020-10-20",
        "last_updated": "2024-11-19",
        "certification_date": "2024-11-19",
        "status": "A",
        "authorized_official_last_name": "HUGGINS",
        "authorized_official_first_name": "LINDA",
        "authorized_official_title_or_position": "VP OF ACCOUNTS RECEIVABLE",
        "authorized_official_telephone_number": "817-348-8959"
    },
    "taxonomies": [
        {
            "code": "314000000X",
            "taxonomy_group": "",
            "desc": "Skilled Nursing Facility",
            "state": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Lake Lodge Nursing & Rehabilitation",
            "code": "3",
            "type": "Doing Business As"
        },
        {
            "organization_name": "Lake Lodge Nursing & Rehabilitation",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Lake Worth, TX

Sources for this page

Verify at the official NPI Registry.