Provider Demographics
NPI:1912224940
Name:MUENSTER I ENTERPRISES, LLC
Entity Type:Organization
Organization Name:MUENSTER I ENTERPRISES, LLC
Other - Org Name:MUENSTER 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:817-348-8841
Mailing Address - Street 1:711 W DIVISION ST
Mailing Address - Street 2:
Mailing Address - City:MUENSTER
Mailing Address - State:TX
Mailing Address - Zip Code:76252-2644
Mailing Address - Country:US
Mailing Address - Phone:940-759-2219
Mailing Address - Fax:940-759-5803
Practice Address - Street 1:711 W DIVISION ST
Practice Address - Street 2:
Practice Address - City:MUENSTER
Practice Address - State:TX
Practice Address - Zip Code:76252-2644
Practice Address - Country:US
Practice Address - Phone:940-759-2219
Practice Address - Fax:940-759-5803
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2010-04-30
Last Update Date:2010-07-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes314000000XNursing & Custodial Care FacilitiesSkilled Nursing Facility
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX004867OtherFACILITY ID
676070Medicare Oscar/Certification