Groveton I Enterprises, LLC

Primary specialty

Assisted Living FacilityTaxonomy code 310400000X

Legal business name

GROVETON I ENTERPRISES, LLC

Doing business as

Groveton Assisted Living

Practice address

1020 W 1St Street
Groveton, TX 75845

Phone

(936) 642-1221

Fax

(936) 642-2727

NPI assigned

Sep 30, 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) 348-8841

Specialties & licenses 1

Addresses

Other identifiers 1

Other names 1

• Groveton Assisted Living Doing business as

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

{
    "created_epoch": "1222732800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1222732800000",
    "number": "1568612299",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 890",
            "city": "GROVETON",
            "state": "TX",
            "postal_code": "758450890",
            "telephone_number": "936-642-1221",
            "fax_number": "936-642-2727"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1020 W 1ST STREET",
            "city": "GROVETON",
            "state": "TX",
            "postal_code": "75845",
            "telephone_number": "936-642-1221",
            "fax_number": "936-642-2727"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "GROVETON I ENTERPRISES, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2008-09-30",
        "last_updated": "2008-09-30",
        "status": "A",
        "authorized_official_last_name": "BLAKE",
        "authorized_official_first_name": "GARY",
        "authorized_official_title_or_position": "MANAGING MEMBER",
        "authorized_official_telephone_number": "817-348-8841"
    },
    "taxonomies": [
        {
            "code": "310400000X",
            "taxonomy_group": "",
            "desc": "Assisted Living Facility",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "STATE VENDOR",
            "identifier": "000502",
            "state": "TX"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Groveton Assisted Living",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

• Ira Richard Gillum, PA C
• Laura Lea Glover, LVN
• Golden Pond Counseling
• Groveton Emergency Medical Service Inc
• Groveton I Enterprises LLC (Groveton Nursing Home)
• Groveton Independent School District
• Groveton Texas Hospital Authority
• Groveton Texas Hospital Authority (Goveton Nursing Home)
• Ruth Nicole Johnson, RN
• Keith Edward Jones, PA-C

• Assisted Living Facility in Groveton, TX
• Providers in Groveton, TX by specialty
• Assisted Living Facility in Texas

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 30, 2008; 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.