NPIMap

Organization Active NPI

Beaumont I Enterprises, LLC

Doing business as Beaumont Nursing and Rehabilitation

  • Skilled Nursing Facility
  • Beaumont, TX
National Provider Identifier
1871873398
Registry record updated Aug 30, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Skilled Nursing FacilityTaxonomy code 314000000X
Legal business name
BEAUMONT I ENTERPRISES, LLC
Doing business as
Beaumont Nursing and Rehabilitation
Practice address
1175 Denton St
Beaumont, TX 77707-3913
Phone
(409) 842-3120
Fax
(409) 842-9013
NPI assigned
Aug 29, 2011
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

1175 Denton St
Beaumont, TX 77707-3913

Mailing address

1175 Denton St
Beaumont, TX 77707-3913
Phone (409) 842-3120

Other identifiers 2

IdentifierTypeStateIssuer
004786OtherTXFACILITY ID
001019897MedicaidTX

Other names 1

  • Beaumont 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
O20110928000855 TX Part A Provider - Skilled Nursing Facility 8426229154 Practice locations: Beaumont, TX

NPI to CCN mapping 1

The Medicare certification numbers (CCNs) connected to NPI 1871873398. Details of each certification follow.

Skilled nursing facility certification: CCN 675620

Legal name
BEAUMONT I ENTERPRISES LLC
Doing business as
BEAUMONT NURSING AND REHABILITATION
Certification status
Active
Provider type (POS)
Nursing home – SNF/NF distinct part
Participating since
Aug 14, 1996
Last certification
May 16, 2024
Beds
120
Ownership / control type
Corporation
Multi-facility organization
Creative Solutions in Healthcare
Organization structure
LLCProprietary
Enrollment address
1175 Denton St
Beaumont, TX 77707-3913
Nursing home name
BEAUMONT NURSING AND REHABILITATION
Affiliated entity
CREATIVE SOLUTIONS IN HEALTHCARE

Care Compare: Nursing home

Medicare Care Compare
Listed as
Beaumont Nursing and RehabilitationCCN 675620 · All quality measures
Overall star rating
2 of 5
Health inspections
2 of 5
Staffing
1 of 5
Quality measures
5 of 5
Type
Medicare and Medicaid
Ownership
For profit - Corporation
Certified
Aug 14, 1996
Medicare certification status
ActiveFrom the Provider of Services file
Certified beds
12049.3 residents per day on average
Chain
Creative Solutions in Healthcare149 facilities in the chain
Penalties (3 years)
3Fines totaling $275,992

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 Oct 1, 2011 50%
Gary R Blake Individual 5% Or Greater Indirect Ownership InterestManaging Member Jun 10, 2011 50%
Operational/Managerial ControlManaging Member Oct 1, 2011 50%
Linda F Huggins Individual W-2 Managing EmployeeVP of Accounts Receivable Oct 1, 2011
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 Oct 1, 2011 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 2

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 1

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": "1314576000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1630281600000",
    "number": "1871873398",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1175 DENTON ST",
            "city": "BEAUMONT",
            "state": "TX",
            "postal_code": "777073913",
            "telephone_number": "409-842-3120",
            "fax_number": "409-842-9013"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1175 DENTON ST",
            "city": "BEAUMONT",
            "state": "TX",
            "postal_code": "777073913",
            "telephone_number": "409-842-3120",
            "fax_number": "409-842-9013"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "BEAUMONT I ENTERPRISES, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2011-08-29",
        "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": "004786",
            "state": "TX"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "001019897",
            "state": "TX"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Beaumont Nursing and Rehabilitation",
            "code": "3",
            "type": "Doing Business As"
        },
        {
            "organization_name": "Beaumont Nursing and Rehabilitation",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Beaumont, TX

Sources for this page

Verify at the official NPI Registry.