NPIMap

Organization Active NPI

Cypress at Lake Providence, LLC

Doing business as Cypress at Lake Providence

  • Skilled Nursing Facility
  • Lake Providence, LA
National Provider Identifier
1346223765
Registry record updated Jun 10, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Skilled Nursing FacilityTaxonomy code 314000000X
License
304 Issued in LA
Legal business name
CYPRESS AT LAKE PROVIDENCE, LLC
Doing business as
Cypress at Lake Providence
Practice address
5976 Highway 65 N
Lake Providence, LA 71254-5235
Phone
(318) 559-2248
Fax
(318) 559-3381
NPI assigned
Nov 21, 2005
Last updated
Jun 10, 2026By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jun 10, 2026

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name
Donald J. Knox
Title
Ceo
Phone
(740) 359-5401

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Skilled Nursing Facility 314000000X 304 LA Primary

Addresses

Primary practice location

5976 Highway 65 N
Lake Providence, LA 71254-5235

Mailing address

10401 Linn Station Rd Ste 300
Louisville, KY 40223-3825
Phone (270) 336-1050

Other names 1

  • Cypress at Lake Providence Doing business as

Electronic endpoints 1

TypeEndpointUseAffiliation
CONNECT URL https://199.119.81.30:8291/Gateway/DocumentSubmission/2_0/NhinService/XDRResponse_Service Other eSolutions Inc.

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in LA

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20220103001788 LA Part A Provider - Skilled Nursing Facility 8820489784 Practice locations: Lake Providence, LA

NPI to CCN mapping 1

The Medicare certification numbers (CCNs) connected to NPI 1346223765. Details of each certification follow.

Skilled nursing facility certification: CCN 195585

Legal name
CYPRESS AT LAKE PROVIDENCE, LLC
Doing business as
CYPRESS AT LAKE PROVIDENCE
Certification status
Active
Provider type (POS)
Nursing home – SNF/NF dual certification
Participating since
Jun 10, 2003
Last certification
May 21, 2025
Beds
108
Ownership / control type
Corporation
Multi-facility organization
LA CHC Holdings, LLC
Most recent change of ownership
Dec 1, 2021
Organization structure
LLCProprietary
Enrollment address
5976 US-65
Lake Providence, LA 71254-5253
Nursing home name
CYPRESS AT LAKE PROVIDENCE
Affiliated entity
VOLARE HEALTH

Care Compare: Nursing home

Medicare Care Compare
Listed as
Cypress at Lake ProvidenceCCN 195585 · All quality measures
Overall star rating
1 of 5
Health inspections
1 of 5
Staffing
1 of 5
Quality measures
1 of 5
Type
Medicare and Medicaid
Ownership
For profit - Corporation
Certified
Jun 10, 2003
Medicare certification status
ActiveFrom the Provider of Services file
Certified beds
10867.7 residents per day on average
Chain
Volare Health16 facilities in the chain
Penalties (3 years)
4Fines totaling $74,456

Processed by Care Compare on Aug 1, 2026.

Laboratory certificates & supplier records

Derived by NPIMap

These CMS records do not include an NPI. They are shown because their name and street address match this provider’s.

CLIA laboratory certificates

CLIA numberLaboratoryCertificateExpires
19D0464376Cypress at Lake Providence LLC5976 Highway 65N, Lake Providence, LA 71254Certificate of waiverAug 31, 2026

National Provider Directory

National Provider Directory

Locations

5976 Highway 65 N
Lake Providence, LA 71254
Phone (318) 559-2248

Ownership & related parties

All disclosed owners & managing parties 18

As disclosed on the Medicare enrollment (CMS All Owners files). Individuals include officers, directors and managing employees, who may not hold ownership.

NameRoleSinceShare
Individual Adp of the SNF Dec 1, 2022
Individual Adp of the SNF Jan 1, 2024
La CHC Holdings, LLC Organization, Louisville, KY LLC, Holding company, For-profit, Owned by another organization or individual 5% Or Greater Direct Ownership Interest Dec 1, 2021 100%
Adp of the SNF Dec 1, 2021
Individual Adp of the SNF Jul 25, 2023
Individual Adp of the SNF Nov 28, 2022
Individual Adp of the SNF Feb 24, 2025
Organization, Louisville, KY LLC, Holding company, For-profit Adp of the SNF Nov 28, 2022
Individual Adp of the SNF Mar 18, 2024
Chaim Hagar Individual 5% Or Greater Indirect Ownership Interest Nov 28, 2022 47.5%
Adp of the SNF Dec 1, 2021
Volare Health LLC Organization, Louisville, KY LLC, Management services company, Consulting firm, For-profit Operational/Managerial Control Jan 1, 2024
Adp of the SNF Feb 26, 2025
Cypress at Us65, LLC Organization, Louisville, KY LLC, For-profit, Owned by another organization or individual 5% Or Greater Indirect Ownership Interest Jul 25, 2023 100%
Adp of the SNF Dec 1, 2021
Kay Kovac Individual Operational/Managerial Control Dec 31, 2022
Adp of the SNF Dec 31, 2022
Stacy Clasby Individual Operational/Managerial Control Jan 13, 2025
Adp of the SNF Jan 13, 2025
Donald Knox Individual Corporate OfficerChief Executive Officer Apr 5, 2024 100%
Adp of the SNF Jul 24, 2023
Individual Adp of the SNF Oct 28, 2024
Organization, Hackensack, NJ For-profit Adp of the SNF Feb 26, 2025
LP Land Holdings LLC Organization, Louisville, KY Created for acquisition, LLC, Holding company, For-profit, Owned by another organization or individual 5% Or Greater Mortgage Interest Dec 1, 2021 100%
Adp of the SNF Dec 1, 2021
Eliezer Schwartz Individual 5% Or Greater Indirect Ownership Interest Nov 28, 2022 47.5%
Corporate OfficerManager Aug 22, 2023
Operational/Managerial Control Dec 1, 2021
Adp of the SNF Dec 1, 2021

Owners & managing parties with NPI records 1

Owners and managing parties disclosed on this facility’s Medicare enrollment that are themselves Medicare-enrolled.

  • Kay B Kovac
    • Family Medicine Physician
    • Lake Providence, LA
    • NPI 1326159450

    Adp of the SNF, Operational/Managerial Control

    CMS ownership

Facilities with the same owner 15

Facilities that share an organizational owner with 5% or greater ownership or operational control.

View all 15

Practitioners & affiliated clinicians

Practitioners 3

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

Affiliated clinicians 3

Clinicians who list this facility as an affiliation in Medicare Care Compare.

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1132531200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1781049600000",
    "number": "1346223765",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "10401 LINN STATION RD STE 300",
            "city": "LOUISVILLE",
            "state": "KY",
            "postal_code": "402233825",
            "telephone_number": "270-336-1050"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5976 HIGHWAY 65 N",
            "city": "LAKE PROVIDENCE",
            "state": "LA",
            "postal_code": "712545235",
            "telephone_number": "318-559-2248",
            "fax_number": "318-559-3381"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "CYPRESS AT LAKE PROVIDENCE, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2005-11-21",
        "last_updated": "2026-06-10",
        "certification_date": "2026-06-10",
        "status": "A",
        "authorized_official_last_name": "KNOX",
        "authorized_official_first_name": "DONALD",
        "authorized_official_middle_name": "J.",
        "authorized_official_title_or_position": "CEO",
        "authorized_official_telephone_number": "740-359-5401"
    },
    "taxonomies": [
        {
            "code": "314000000X",
            "taxonomy_group": "",
            "desc": "Skilled Nursing Facility",
            "state": "LA",
            "license": "304",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "CONNECT",
            "endpointTypeDescription": "CONNECT URL",
            "endpoint": "https://199.119.81.30:8291/Gateway/DocumentSubmission/2_0/NhinService/XDRResponse_Service",
            "affiliation": "Y",
            "endpointDescription": "2.16.840.1.113883.3.1066.1",
            "affiliationName": "eSolutions Inc.",
            "use": "OTHER",
            "useDescription": "Other",
            "useOtherDescription": "CMS esMD eMDR",
            "contentType": "OTHER",
            "contentTypeDescription": "Other",
            "contentOtherDescription": "CSV",
            "address_1": "8215 W 108th Ter",
            "city": "Overland Park",
            "state": "KS",
            "country_code": "US",
            "postal_code": "662101661",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": [
        {
            "organization_name": "Cypress at Lake Providence",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Lake Providence, LA

Sources for this page

Verify at the official NPI Registry.