Madisonville III Enterprises, LLC

Primary specialty

Assisted Living FacilityTaxonomy code 310400000X

License

123702 Issued in TX

Legal business name

MADISONVILLE III ENTERPRISES, LLC

Doing business as

Madisonville Assisted Living

Practice address

410 E Collard St
Madisonville, TX 77864-3307

Phone

(936) 348-3985

Fax

(936) 348-3501

NPI assigned

May 9, 2008

Last updated

May 9, 2008By 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

• Madisonville Assisted Living Doing business as

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

{
    "created_epoch": "1210291200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1210291200000",
    "number": "1831366780",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "410 E COLLARD ST",
            "city": "MADISONVILLE",
            "state": "TX",
            "postal_code": "778643307",
            "telephone_number": "936-348-3985",
            "fax_number": "936-348-3501"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "410 E COLLARD ST",
            "city": "MADISONVILLE",
            "state": "TX",
            "postal_code": "778643307",
            "telephone_number": "936-348-3985",
            "fax_number": "936-348-3501"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "MADISONVILLE III ENTERPRISES, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2008-05-09",
        "last_updated": "2008-05-09",
        "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": "TX",
            "license": "123702",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "DEPT AGING & DISABILITY LICENSE",
            "identifier": "123702",
            "state": "TX"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Madisonville Assisted Living",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

• Mac L Bennett III DDS Inc
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• Madison St Joseph Health Center (CHI St Joseph Health Madison Hospital)
• Madisonville Cisd
• Madisonville II Enterprises, LLC (Madisonville Care Center)
• Madisonville Managment (Madisonville Care Center)
• Leigh McWhorter
• Melissa Ann Meyer, MD
• Kelly Elizabeth Morgan, LPC
• Mary Helen Morrow, M.D.

• Assisted Living Facility in Madisonville, TX
• Providers in Madisonville, 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 May 9, 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.