Granbury II Enterprises, LLC

Primary specialty

Assisted Living FacilityTaxonomy code 310400000X

License

000569 Issued in TX

Legal business name

GRANBURY II ENTERPRISES, LLC

Practice address

1017 Lipan Dr
Granbury, TX 76048-1560

Phone

(817) 279-8885

Fax

(817) 569-1908

NPI assigned

Mar 9, 2007

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) 832-3654

Specialties & licenses 1

Addresses

Other identifiers 1

Other names 1

• The Oaks of Granbury Doing business as

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

{
    "created_epoch": "1173398400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1193788800000",
    "number": "1942332671",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1017 LIPAN DR",
            "city": "GRANBURY",
            "state": "TX",
            "postal_code": "760481560",
            "telephone_number": "817-279-8885",
            "fax_number": "817-569-1908"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1017 LIPAN DR",
            "city": "GRANBURY",
            "state": "TX",
            "postal_code": "760481560",
            "telephone_number": "817-279-8885",
            "fax_number": "817-569-1908"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "GRANBURY II ENTERPRISES, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-03-09",
        "last_updated": "2007-10-31",
        "status": "A",
        "authorized_official_last_name": "BLAKE",
        "authorized_official_first_name": "GARY",
        "authorized_official_title_or_position": "MANAGING MEMBER",
        "authorized_official_telephone_number": "817-832-3654"
    },
    "taxonomies": [
        {
            "code": "310400000X",
            "taxonomy_group": "",
            "desc": "Assisted Living Facility",
            "state": "TX",
            "license": "000569",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "000569",
            "state": "TX"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "The Oaks of Granbury",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

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• Assisted Living Facility in Granbury, TX
• Providers in Granbury, 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 Oct 31, 2007; 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.