Basic Information
Provider Information
NPI: 1659788032
EntityType: 2
ReplacementNPI:  
OrganizationName: ANGLETON HEALTH FACILITIES LP
LastName:  
FirstName:  
MiddleName:  
NamePrefix:  
NameSuffix:  
Credential:  
OtherOrganizationName: CYPRESS WOODS CARE CENTER
OtherOrganizationType: 3
OtherLastName:  
OtherFirstName:  
OtherMiddleName:  
OtherNamePrefix:  
OtherNameSuffix:  
OtherCredential:  
OtherLastNameType:  
Mailing Information
Address1: 5420 W PLANO PKWY
Address2:  
City: PLANO
State: TX
PostalCode: 750934823
CountryCode: US
TelephoneNumber: 9729313800
FaxNumber: 9727676222
Practice Location
Address1: 135 1/2 E HOSPITAL DR
Address2:  
City: ANGLETON
State: TX
PostalCode: 775154111
CountryCode: US
TelephoneNumber: 9798498221
FaxNumber: 9798644106
Other Information
ProviderEnumerationDate: 07/17/2014
LastUpdateDate: 01/12/2016
NPIDeactivationReasonCode:  
NPIDeactivationDate:  
NPIReactivationDate:  
ProviderGenderCode:  
AuthorizedOfficialLastName: COLLIER
AuthorizedOfficialFirstName: JAMIE
AuthorizedOfficialMiddleName:  
AuthorizedOfficialTitleorPosition: DIRECTOR OF REIMBURSEMENT
AuthorizedOfficialTelephone: 9729313800
IsSoleProprietor:  
IsOrganizationSubpart: N
ParentOrganizationLBN:  
AuthorizedOfficialNamePrefix: MRS.
AuthorizedOfficialNameSuffix:  
AuthorizedOfficialCredential:  
NPICertificationDate:  

Taxonomy Information
TaxonomyLicenseStateSwitchTaxonomyGroupTaxonomyTypeTaxonomyClassSubSpecialty
314000000X  Y Nursing & Custodial Care FacilitiesSkilled Nursing Facility 

ID Information
IDTypeStateIssuerDescription
00102630105TX MEDICAID


Home