Cypress Village

LBN: Ccrc Opco - Cypress Village, Llc
Cypress Village is an health care organization with primary practice located at 4600 Middleton Park Cir E , Jacksonville FL 32224-5691. The organization recently has 2 registered licenses in different health care specialties including Nursing & Custodial Care Facilities / Assisted Living Facility, Nursing & Custodial Care Facilities / Skilled Nursing Facility. Nursing & Custodial Care Facilities / Skilled Nursing Facility is the primary health care specialty. Ccrc Opco - Cypress Village, Llc can be contacted via phone (901) 223-6100, or through Ohlendorf, Mark W via phone (414) 918-5000.

Contact Information

Primary practice address
4600 Middleton Park Cir E Jacksonville FL 32224-5691
Phone: (901) 223-6100
Fax:
Website:
Map and Directions
Authorized official contact:
Name: Ohlendorf, Mark W
Phone: (414) 918-5000

Health care specialties

SpecialtyCodeLicense #State
Nursing & Custodial Care Facilities / Assisted Living Facility 310400000X AL7720 Florida
Nursing & Custodial Care Facilities / Skilled Nursing Facility 314000000X SNF11170961 Florida

Profile Details

NPI number 1760431399
LBN Legal business name Ccrc Opco - Cypress Village, Llc
DBA Doing business as Cypress Village
Authorized official Ohlendorf, Mark W
Entity Organization
Organization subpart 1 Yes
Enumeration date May 10th, 2006
Last updated Oct 3rd, 2014 - about 11 years ago

1 Some organizations, which are providing health care services, may consist of units or departments that provide different types of health care services or have several separate physical locations, where health care service is provided. These units, departments or physical locations are not themselves legal entities. However, each of them is part of the organization, which is a legal entity. The organization may decide whether its subparts, if it has any, should have their own NPI numbers. In case a subpart conducts any HIPAA standard transactions by itself, without its parent's involvement, it must have its own NPI number.

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Identifiers

StateTypeNumberIssuer
All States NPI 1760431399 NPPES
Florida MEDICAID 30799800

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