Cypress Place Assisted Living

Organization Active NPI Assisted Living Facility · Jefferson, TX

NPI 1992887657 · NPPES record last updated Jun 25, 2008

Key facts

NPI
1992887657
Entity type
Organization (NPI type 2)
Primary specialty
Assisted Living Facility 310400000X
License
117430 (TX)
Legal business name
CYPRESS PLACE ASSISTED LIVING
Practice address
100 W Douglas St
Jefferson, TX 75657-1206
Phone
(903) 665-9855
Fax
(903) 665-6806
NPI assigned
Oct 20, 2006
Organization subpart
No

Authorized official

Name
Mrs. Julius E Cox
Title
Administrator
Phone
(903) 665-9855

Corporate family (same tax ID) 1

Organizations that report the same tax identification number in the National Provider Directory.

National Provider Directory

Tax ID family
Cypress Place Assisted Living (2 organizations share this tax ID)

Specialties & licenses

Specialty (taxonomy)CodeLicenseStatePrimary
Assisted Living Facility 310400000X 117430 TX Yes

Addresses

Primary practice location

100 W Douglas St
Jefferson, TX 75657-1206

Mailing address

100 W Douglas St
Jefferson, TX 75657-1206
Phone (903) 665-9855

Other identifiers

IdentifierTypeStateIssuer
001000877MedicaidTX

Other providers in Jefferson, TX

All providers in Jefferson, TX · Assisted Living Facility in Texas

Sources for this page

Verify at the official NPI Registry.