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WOLFFORTH I ENTERPRISES LLC NPI 1952596009


NPI Information

NPI: 1952596009
Provider Name: WOLFFORTH I ENTERPRISES, LLC

Doing Business As: VILLA RESIDENTIAL CARE OF WOLFFORTH I, II, III

Classification: Assisted Living Facility - 310400000X
Entity Type: Organization

CLIA Number: 45D0912948

Address:
301 E 5TH ST
WOLFFORTH, TX
ZIP 79382
Phone: (806) 866-4666
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WOLFFORTH I ENTERPRISES, LLC is an assisted living facility in Wolfforth, TX. The provider is a facility providing supportive services to individuals who can function independently in most areas of activity, but need assistance and/or monitoring to assure safety and well being. WOLFFORTH I ENTERPRISES, LLC NPI is 1952596009. The provider is registered as an organization entity type.
The provider Is Doing Business As Villa Residential Care Of Wolfforth I, Ii, Iii.

The provider's business location address is:

301 E 5TH ST
WOLFFORTH, TX
ZIP 79382
Phone: (806) 866-4666
Fax: (806) 866-4111

The provider's authorized official is Gary Blake .
The authorized official title is Managing Member and has the following contact phone number (817) 832-3654.

The CLIA number assigned to this NPI record is 45D0912948 - community clinic with a certificate type of Certificate of Waiver.

The enumeration date for this NPI number is 9/12/2007 and was last updated on 9/12/2007.


Taxonomy Codes

The NPI record includes the healthcare provider taxonomy classification, state license number and state of licensure. The following information regarding the scope of practice of this provider is available:

No. Taxonomy Code Taxonomy Clasification Taxonomy Specialization License Number License State Primary
1310400000XAssisted Living FacilityYes

What is NPI?

NPI stands for National Provider Identifier. The NPI is a 10-digit identification number that is completely unique. The NPI number by itself does not contain any identifiable information such as a provider’s speciality or location. The NPI is assigned to individuals or organizacions for their lifespan and it is independent of key provider information type updates like a change of practices, location or speciality.

This page was last updated on: 5/5/2024

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