College Station I Enterprises, L.l.c.

NPI Registration Record

Provider / Organization	NPI	Date Certified
COLLEGE STATION I ENTERPRISES, L.L.C.	1063054823	2024-11-08

The organization College Station I Enterprises, L.l.c. is registered with the National Plan and Provider Enumeration System (NPPES) and has the assigned NPI of 1063054823. Registration indicates College Station I Enterprises, L.l.c. is a provider of access to skilled nursing facilities services with a specialization in Nursing & Custodial Care Facilities, Skilled Nursing Facility (Nursing & Custodial Care Facilities, Skilled Nursing Facility) (Skilled Nursing Facility, ) (All Other Specialties & Provider Types, ) (Skilled Nursing Facility, Nursing & Custodial Care Facilities)

Other Names:

• Fortress Nursing and Rehabilitation

Entity Type	Organization
Provider Organization	COLLEGE STATION I ENTERPRISES, L.L.C.
Other Provider Organization	FORTRESS NURSING AND REHABILITATION
Practice Office Address	1105 ROCK PRAIRIE RD COLLEGE STATION, TX US
Practice Office Telephone	9796942200
Mailing Address	4150 INTERNATIONAL PLZ STE 200 FORT WORTH, TX 761094875 US
Business Telephone	8173488959
Authorized Official	GARY BLAKE, MANAGING MEMBER 8173488959

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