CYPRESS PLACE RE 2015, LLC (NPI# 1790150308) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1790150308 |
| Entity Type | Organization |
| Organization Name | CYPRESS PLACE RE 2015, LLC |
| Other Organization Name | CYPRESS PLACE ASSISTED LIVING |
| Practice Address |
100 W Douglas St Jefferson TX 75657-1206 |
| Mailing Address |
3973 W Vickery Blvd Suite 101 Fort Worth TX 76107-6492 |
| Practice Telephone | 9036659855 |
| Enumeration Date | 2015-12-08 |
| Last Update Date | 2015-12-08 |
| Authorized Official Name | LAWRENCE WAYNE POWELL (PRESIDENT) |
| Authorized Official Telephone | 8173868888 |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 310400000X | Assisted Living Facility | TX | Nursing & Custodial Care Facilities |
| Other Name | Type Code |
|---|---|
| Cypress Place Assisted Living | Doing Business As Name - Organization |
| Street Address |
100 W DOUGLAS ST |
| City | JEFFERSON |
| State | TX |
| Zip Code | 75657-1206 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1992887657 | Cypress Place Assisted Living | Assisted Living Facility | 100 W Douglas St, Jefferson, TX 75657-1206 | 2006-10-20 |
| 1013108356 | Jefferson Holdings Management Inc. | Assisted Living Facility | 100 W Douglas St, Jefferson, TX 75657-1206 | 2007-08-01 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1780131995 | Kimberly George | Case Manager/Care Coordinator | 261 Ma County Road 3430, Jefferson, TX 75657 | 2016-09-06 |
| 1124116561 | The Med Shop | Durable Medical Equipment & Medical Supplies | 110 N . Walnut, Jefferson, TX 75657 | 2006-10-11 |
| 1487644068 | Denise Sepulvado Norris | Occupational Therapist | 1404 Marion County Road 3509, Jefferson, TX 75657 | 2005-10-25 |
| 1700870185 | Robin Lynne Gale | Nurse Practitioner | 219 N Polk St, Jefferson, TX 75657 | 2005-08-31 |
| 1700072477 | James Leo Carroll | Physical Therapy Assistant | 339 Tangiers, Jefferson, TX 75657-0598 | 2007-09-17 |
| 1952397739 | Pine Hill Nursing and Rehabilitation Lp | Skilled Nursing Facility | 1307 Martin Luther King Dr, Jefferson, TX 75657-1009 | 2005-09-27 |
| 1124495486 | Fannin County Hospital Authority | Skilled Nursing Facility | 1307 Martin Luther King Dr, Jefferson, TX 75657-1009 | 2015-08-21 |
| 1598910291 | Jefferson I Enterprises, LLC | Skilled Nursing Facility | 1307 Martin Luther King Dr, Jefferson, TX 75657-1009 | 2008-11-21 |
| 1558404293 | Jefferson Isd | Local Education Agency (LEA) | 1600 Martin Luther King Dr, Jefferson, TX 75657-1061 | 2007-02-14 |
| 1730352667 | Demetria Rena Parker | Nurse's Aide | 506 E Harrison St, Jefferson, TX 75657-1106 | 2008-04-11 |
| Find all providers in zip 75657 | ||||
| Taxonomy Code | 310400000X |
| Grouping | Nursing & Custodial Care Facilities |
| Classification | Assisted Living Facility |
| A facility providing supportive services to individuals who can function independently in most areas of activity, but need assistance and/or monitoring to assure safety and well being. |
| Notes: [7/1/2003: new] |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1093363657 | Dean Harley Schwieso I | Assisted Living Facility | N5835 County Rd N, Jefferson, WI 53549-9698 | 2019-08-27 |
| 1235334178 | Jefferson Care Center | Assisted Living Facility | 121 Brook St, Jefferson, NC 28640 | 2007-06-20 |
| 1609077338 | Eldercare Network of Lincoln County | Assisted Living Facility | 77 Waldoboro Rd, Jefferson, ME 04348-3875 | 2007-05-30 |
| 1992887657 | Cypress Place Assisted Living | Assisted Living Facility | 100 W Douglas St, Jefferson, TX 75657-1206 | 2006-10-20 |
| 1013108356 | Jefferson Holdings Management Inc. | Assisted Living Facility | 100 W Douglas St, Jefferson, TX 75657-1206 | 2007-08-01 |
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| Find all providers with the same taxonomy | ||||
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| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.