Bob & Nick Enterprises, Inc

Primary specialty

Skilled Nursing FacilityTaxonomy code 314000000X

License

117694 Issued in TX

Legal business name

BOB & NICK ENTERPRISES, INC

Doing business as

Eventide Nursing Home, Inc.

Practice address

1405 W Storey St
San Saba, TX 76877-6422

Phone

(325) 372-3675

Fax

(325) 372-5114

NPI assigned

Oct 27, 2006

Last updated

Aug 22, 2020By 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

Miss Enedina M Diaz, LNFA

Title

Administrator

Phone

(325) 372-5112

Specialties & licenses 1

Addresses

Other names 1

• Eventide Nursing Home, Inc. Doing business as

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

{
    "created_epoch": "1161907200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1598054400000",
    "number": "1306922133",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1405 W STOREY ST",
            "city": "SAN SABA",
            "state": "TX",
            "postal_code": "768776422",
            "telephone_number": "325-372-3675",
            "fax_number": "325-372-5114"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1405 W STOREY ST",
            "city": "SAN SABA",
            "state": "TX",
            "postal_code": "768776422",
            "telephone_number": "325-372-3675",
            "fax_number": "325-372-5114"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "BOB & NICK ENTERPRISES, INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-10-27",
        "last_updated": "2020-08-22",
        "status": "A",
        "authorized_official_last_name": "DIAZ",
        "authorized_official_first_name": "ENEDINA",
        "authorized_official_middle_name": "M",
        "authorized_official_title_or_position": "ADMINISTRATOR",
        "authorized_official_telephone_number": "325-372-5112",
        "authorized_official_name_prefix": "Miss",
        "authorized_official_credential": "LNFA"
    },
    "taxonomies": [
        {
            "code": "314000000X",
            "taxonomy_group": "",
            "desc": "Skilled Nursing Facility",
            "state": "TX",
            "license": "117694",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Eventide Nursing Home, Inc.",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

• Brownwood Hospital LP (One Source Health Center San Sabbath)
• Tamra Lynn Deland, FNP
• Shannon Louise Dennis, LCSW
• Michiel Cord Dyson, PT
• El Campo Memorial Hospital

• Skilled Nursing Facility in San Saba, TX
• Providers in San Saba, 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 Aug 22, 2020; 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.