Organization
CYPRESS PLACE RE 2015, LLC
Active
Other names
Cypress Place Assisted Living
Organization subpart
No
Provider details
NPI number
Authorized official
LAWRENCE WAYNE POWELL (PRESIDENT)
(817) 386-8888
Entity
Organization
Contact information
Practice address
100 W DOUGLAS ST, JEFFERSON, TX 75657-1206
(903) 665-9855
Mailing address
3973 W VICKERY BLVD, SUITE 101, FORT WORTH, TX 76107-6492
Taxonomy
Speciality
Code
Description
License number
State
310400000X
Assisted Living Facility
Primary
—
TX
Other
Enumeration date
12/08/2015
Last updated
12/08/2015
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