Provider Demographics
NPI:1871540005
Name:CYPRESS HEALTHCARE, LLC
Entity type:Organization
Organization Name:CYPRESS HEALTHCARE, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CFO
Authorized Official - Prefix:
Authorized Official - First Name:AARON
Authorized Official - Middle Name:
Authorized Official - Last Name:MAUER
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:847-902-9586
Mailing Address - Street 1:1400 POPLAR ST
Mailing Address - Street 2:
Mailing Address - City:HANCOCK
Mailing Address - State:MI
Mailing Address - Zip Code:49930-1121
Mailing Address - Country:US
Mailing Address - Phone:906-482-6644
Mailing Address - Fax:906-482-0983
Practice Address - Street 1:1400 POPLAR ST
Practice Address - Street 2:
Practice Address - City:HANCOCK
Practice Address - State:MI
Practice Address - Zip Code:49930-1121
Practice Address - Country:US
Practice Address - Phone:906-482-6644
Practice Address - Fax:906-482-0983
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-05-31
Last Update Date:2016-10-31
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MI314020314000000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes314000000XNursing & Custodial Care FacilitiesSkilled Nursing Facility
Provider Identifiers
StateIdentifier IDID TypeIssuer
MI4639928Medicaid
235552Medicare Oscar/Certification