Cypress Place Re 2015, LLC

NPI #1790150308 in Jefferson, Texas

Provider Information

NPI Number
1790150308
Entity Type
Organization
Organization Name
Cypress Place Re 2015, LLC
Primary Specialty
Assisted Living Facility
Enumeration Date
Dec 8, 2015
Last Updated
Dec 8, 2015

Practice Location

Address
100 W DOUGLAS ST
State
Texas
ZIP Code
75657-1206
Phone
(903) 665-9855

Authorized Official

Name
LAWRENCE WAYNE POWELL
Title
PRESIDENT
Phone
(817) 386-8888

Specialties & Taxonomy Codes

Specialty
Assisted Living Facility

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