Caldwell II Enterprises, LLC

Primary specialty

Skilled Nursing FacilityTaxonomy code 314000000X

Legal business name

CALDWELL II ENTERPRISES, LLC

Doing business as

Copperas Hollow Nursing & Rehabilitation Center

Practice address

345 Country Club Dr
Caldwell, TX 77836-2328

Phone

(979) 567-4300

Fax

(979) 567-4315

NPI assigned

Mar 31, 2009

Last updated

Jul 22, 2009By 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 1

Other names 1

• Copperas Hollow Nursing & Rehabilitation Center Doing business as

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

{
    "created_epoch": "1238457600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1248220800000",
    "number": "1700028289",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "345 COUNTRY CLUB DR",
            "city": "CALDWELL",
            "state": "TX",
            "postal_code": "778362328",
            "telephone_number": "979-567-4300",
            "fax_number": "979-567-4315"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "345 COUNTRY CLUB DR",
            "city": "CALDWELL",
            "state": "TX",
            "postal_code": "778362328",
            "telephone_number": "979-567-4300",
            "fax_number": "979-567-4315"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "CALDWELL II ENTERPRISES, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2009-03-31",
        "last_updated": "2009-07-22",
        "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": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "001017065",
            "state": "TX"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Copperas Hollow Nursing & Rehabilitation Center",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

• Burleson St. Joseph Health Center of Caldwell, Texas
• Burleson St. Joseph Health Center of Caldwell, Texas
• Burleson St. Joseph Manor
• Sherri Busby, OTA
• Caldwell I Enterprises, LLC (Copperas Hollow Assisted Living)
• Caldwell Isd
• Caldwell IV Enterprises, LLC (Copperas Hollow Assited Living)
• Caldwell Nursing and Rehab Center (Copperas Hollow Nursing and Rehab Center)
• Karla Gail Chaloupka, RRT
• John Scott Chennault, D.O.

• Skilled Nursing Facility in Caldwell, TX
• Providers in Caldwell, 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 Jul 22, 2009; 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.