Goldthwaite I Enterprises, LLC

Primary specialty

Skilled Nursing FacilityTaxonomy code 314000000X

Legal business name

GOLDTHWAITE I ENTERPRISES, LLC

Doing business as

Goldthwaite Health & Rehabilitation Center

Practice address

1207 Reynolds St
Goldthwaite, TX 76844-2475

Phone

(325) 648-2258

Fax

(325) 648-3496

NPI assigned

Aug 26, 2009

Last updated

Feb 25, 2015By the provider in NPPES

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) 348-8841

Specialties & licenses 1

Addresses

Other identifiers 2

Other names 1

• Goldthwaite Health & Rehabilitation Center Doing business as

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

{
    "created_epoch": "1251244800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1424822400000",
    "number": "1205069101",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1207 REYNOLDS ST",
            "city": "GOLDTHWAITE",
            "state": "TX",
            "postal_code": "768442475",
            "telephone_number": "325-648-2258",
            "fax_number": "325-648-3496"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1207 REYNOLDS ST",
            "city": "GOLDTHWAITE",
            "state": "TX",
            "postal_code": "768442475",
            "telephone_number": "325-648-2258",
            "fax_number": "325-648-3496"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "GOLDTHWAITE I ENTERPRISES, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2009-08-26",
        "last_updated": "2015-02-25",
        "status": "A",
        "authorized_official_last_name": "BLAKE",
        "authorized_official_first_name": "GARY",
        "authorized_official_title_or_position": "MANAGING MEMBER",
        "authorized_official_telephone_number": "817-348-8841"
    },
    "taxonomies": [
        {
            "code": "314000000X",
            "taxonomy_group": "",
            "desc": "Skilled Nursing Facility",
            "state": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "STATE LICENSE",
            "identifier": "004411",
            "state": "TX"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "001017724",
            "state": "TX"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Goldthwaite Health & Rehabilitation Center",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

• Jenny Rebecca Dabney, MPT
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• Dallas Central Physical Therapy Inc.
• Jesse Amanda Dellis, LPC
• Crystal Dowell, FNP
• Goldthwaite Isd
• Goldthwaite Nursing Operations, LLC
• Goldthwaite Senior Health Center, Inc (Goldthwaite Senior Health Center)
• Jesus Mesa Gonzalez Jr., PA-C
• Luiza Gomez Grajales, LCSW

• Skilled Nursing Facility in Goldthwaite, TX
• Providers in Goldthwaite, 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 25, 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.