NPIMap

Organization Active NPI

Eagle Pass I Enterprises, LLC

Doing business as Eagle Pass Nursing and Rehabilitation

  • Skilled Nursing Facility
  • Eagle Pass, TX
National Provider Identifier
1225309172
Registry record updated Aug 30, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Skilled Nursing FacilityTaxonomy code 314000000X
Legal business name
EAGLE PASS I ENTERPRISES, LLC
Doing business as
Eagle Pass Nursing and Rehabilitation
Practice address
2550 Zacatecas Dr
Eagle Pass, TX 78852-4129
Phone
(830) 773-4488
Fax
(830) 773-9681
NPI assigned
Jan 24, 2012
Last updated
Aug 30, 2021By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Aug 30, 2021

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

Authorized official

Name
Mr. Gary Blake
Title
Managing Member
Phone
(817) 348-8959

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Skilled Nursing Facility 314000000X Primary

Addresses

Primary practice location

2550 Zacatecas Dr
Eagle Pass, TX 78852-4129

Mailing address

2550 Zacatecas Dr
Eagle Pass, TX 78852-4129
Phone (830) 773-4488

Other identifiers 2

IdentifierTypeStateIssuer
005009OtherTXFACILITY ID
001020253MedicaidTX

Other names 1

  • Eagle Pass Nursing and Rehabilitation Doing business as

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20120326000774 TX Part A Provider - Skilled Nursing Facility 9830359041 Practice locations: Eagle Pass, TX

NPI to CCN mapping 1

The Medicare certification numbers (CCNs) connected to NPI 1225309172. Details of each certification follow.

Skilled nursing facility certification: CCN 675617

Legal name
EAGLE PASS I ENTERPRISES LLC
Doing business as
EAGLE PASS NURSING AND REHABILITATION
Certification status
Active
Provider type (POS)
Nursing home – SNF/NF distinct part
Participating since
Aug 1, 1996
Last certification
Apr 17, 2024
Beds
114
Ownership / control type
Hospital District
Multi-facility organization
Creative Solutions in Healthcare
Most recent change of ownership
Mar 1, 2012
Organization structure
LLCProprietary
Enrollment address
2550 Zacatecas Dr
Eagle Pass, TX 78852-4129
Nursing home name
EAGLE PASS NURSING AND REHABILITATION
Affiliated entity
CREATIVE SOLUTIONS IN HEALTHCARE

Care Compare: Nursing home

Medicare Care Compare
Listed as
Eagle Pass Nursing and RehabilitationCCN 675617 · All quality measures
Overall star rating
3 of 5
Health inspections
4 of 5
Staffing
1 of 5
Quality measures
3 of 5
Type
Medicare and Medicaid
Ownership
Government - Hospital district
Certified
Aug 1, 1996
Medicare certification status
ActiveFrom the Provider of Services file
Certified beds
11461.0 residents per day on average
Chain
Creative Solutions in Healthcare149 facilities in the chain
Penalties (3 years)
2Fines totaling $17,419

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 Jun 10, 2011 50%
Operational/Managerial ControlMember Mar 1, 2012 50%
Gary R Blake Individual 5% Or Greater Indirect Ownership InterestManaging Member Jun 10, 2011 50%
Operational/Managerial ControlManaging Member Mar 1, 2012 50%
Linda F Huggins Individual W-2 Managing EmployeeVP of Accounts Receivable Mar 1, 2012
Honor X Enterprises, LLC Organization, Fort Worth, TX LLC, For-profit 5% Or Greater Direct Ownership Interest Jan 9, 2013 100%
Creative Solutions in Healthcare Inc Organization, Fort Worth, TX Corporation, Management services company, For-profit Operational/Managerial Control Mar 1, 2012 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 6

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": "1327363200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1630281600000",
    "number": "1225309172",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2550 ZACATECAS DR",
            "city": "EAGLE PASS",
            "state": "TX",
            "postal_code": "788524129",
            "telephone_number": "830-773-4488",
            "fax_number": "830-773-9681"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2550 ZACATECAS DR",
            "city": "EAGLE PASS",
            "state": "TX",
            "postal_code": "788524129",
            "telephone_number": "830-773-4488",
            "fax_number": "830-773-9681"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "EAGLE PASS I ENTERPRISES, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2012-01-24",
        "last_updated": "2021-08-30",
        "certification_date": "2021-08-30",
        "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",
        "authorized_official_name_prefix": "Mr."
    },
    "taxonomies": [
        {
            "code": "314000000X",
            "taxonomy_group": "",
            "desc": "Skilled Nursing Facility",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "FACILITY ID",
            "identifier": "005009",
            "state": "TX"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "001020253",
            "state": "TX"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Eagle Pass Nursing and Rehabilitation",
            "code": "3",
            "type": "Doing Business As"
        },
        {
            "organization_name": "Eagle Pass Nursing and Rehabilitation",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Eagle Pass, TX

Sources for this page

Verify at the official NPI Registry.