Organization
CYPRESS COVE CARE CENTER, LLC
Active
Other names
Cypress Cove Care Center
Organization subpart
No
Provider details
NPI number
Authorized official
SCOTT FISHER (CFO)
(352) 417-0360
Entity
Organization
Contact information
Practice address
700 SE DR. MARTIN LUTHER KING JR. AVENUE, CRYSTAL RIVER, FL 34429-4855
(352) 795-8832
(352) 795-0490
Mailing address
700 SE DR. MARTIN LUTHER KING AVE, CRYSTAL RIVER, FL 34429-4855
(352) 795-8832
(352) 795-0490
Taxonomy
Speciality
Code
Description
License number
State
313M00000X
Nursing Facility/Intermediate Care Facility
Primary
SNF1115096
FL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
022894000
—
FL
Enumeration date
08/09/2005
Last updated
09/07/2023
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