Organization
CYPRESS INN ASSISTED LIVING CENTER
Active
Organization subpart
No
Provider details
NPI number
Authorized official
EMERITA AQUINO (EXECUTIVE DIRECTOR-PRESIDENT)
(520) 364-7232
Entity
Organization
Contact information
Practice address
757 E 12TH ST, DOUGLAS, AZ 85607-1934
(520) 364-7232
(520) 364-5322
Mailing address
757 E 12TH ST, DOUGLAS, AZ 85607-1934
(520) 364-7232
(520) 364-5322
Taxonomy
Speciality
Code
Description
License number
State
261QM0850X
Adult Mental Health Clinic/Center
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
709719
AHCCCS
AZ
Enumeration date
05/29/2007
Last updated
08/22/2020
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