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Organization
CYPRESS GLEN RETIREMENT COMMUNITY
Active
Organization
CYPRESS GLEN RETIREMENT COMMUNITY
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MR. DONALD E. METZGER SR. (CHAIRMAN OF THE BOARD)
(910) 738-4652
Entity
Organization
Contact information
Practice address
100 HICKORY STREET, GREENVILLE, NC 27585-1637
(252) 830-0036
(252) 830-0411
Mailing address
100 HICKORY STREET, GREENVILLE, NC 27585-1637
(252) 830-0036
(252) 830-0411
Taxonomy
Speciality
Code
Description
License number
State
314000000X
Skilled Nursing Facility
Primary
NH0473
NC
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
009CH
BLIE CROSS AND BLUE SHILE
NC
Enumeration date
12/01/2005
Last updated
08/11/2011
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