Healthcare Provider Details

I. General information

NPI: 1437117256
Provider Name (Legal Business Name): WARD & BLAKE INVESTMENTS, LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 05/02/2006
Last Update Date: 10/31/2007
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2601 W RANDOL MILL RD
ARLINGTON TX
76012-4289
US

IV. Provider business mailing address

2601 W RANDOL MILL RD
ARLINGTON TX
76012-4289
US

V. Phone/Fax

Practice location:
  • Phone: 817-274-5571
  • Fax: 817-274-4341
Mailing address:
  • Phone: 817-274-5571
  • Fax: 817-274-4341

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code314000000X
TaxonomySkilled Nursing Facility
License Number112969
License Number StateTX

VIII. Authorized Official

Name: GARY BLAKE
Title or Position: MANAGING MEMBER
Credential:
Phone: 817-348-8959