Provider Demographics
NPI:1578518924
Name:LUFKIN I ENTERPRISES, LLC
Entity Type:Organization
Organization Name:LUFKIN I ENTERPRISES, LLC
Other - Org Name:CASTLE PINES HEALTH & REHABILITATION
Other - Org Type:Doing Business As
Authorized Official - Title/Position:MANAGING MEMBER
Authorized Official - Prefix:
Authorized Official - First Name:GARY
Authorized Official - Middle Name:
Authorized Official - Last Name:BLAKE
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:817-348-8959
Mailing Address - Street 1:2414 WEST FRANK AVE
Mailing Address - Street 2:
Mailing Address - City:LUFKIN
Mailing Address - State:TX
Mailing Address - Zip Code:75904-3521
Mailing Address - Country:US
Mailing Address - Phone:936-699-2544
Mailing Address - Fax:936-699-3355
Practice Address - Street 1:2414 WEST FRANK AVE
Practice Address - Street 2:
Practice Address - City:LUFKIN
Practice Address - State:TX
Practice Address - Zip Code:75904-3521
Practice Address - Country:US
Practice Address - Phone:936-699-2544
Practice Address - Fax:936-699-3355
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-05-24
Last Update Date:2021-08-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes314000000XNursing & Custodial Care FacilitiesSkilled Nursing Facility
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX001014208Medicaid
TX5440OtherVENDOR #
TX180846101Medicaid
TX180846101Medicaid