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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