Fort Worth Vi Enterprises, LLC
NPI #1407605165 in Fort Worth, Texas
Provider Information
- NPI Number
- 1407605165
- Entity Type
- Organization
- Organization Name
- Fort Worth Vi Enterprises, LLC
- Primary Specialty
- Skilled Nursing Facility
- Enumeration Date
- May 15, 2024
- Last Updated
- May 15, 2024
Practice Location
- Address
- 2416 NW 18TH ST
- City
- Fort Worth
- State
- Texas
- ZIP Code
- 76106-6604
- Phone
- (817) 626-5454
Authorized Official
- Name
- GARY BLAKE
- Title
- MANAGING MEMBER
- Phone
- (817) 348-8959
Specialties & Taxonomy Codes
| Specialty |
|---|
| Skilled Nursing Facility |
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