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NPI Code Detail

MEDICARE: WOODSTOCK CYPRESS LLC

MEDICARE: WOODSTOCK CYPRESS LLC
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1314000000XSkilled Nursing Facility

General Provider Information

NPI Number : 1942621917
Entity Type Code : Organization
Provider Name (Legal Business Name) : WOODSTOCK CYPRESS LLC
Provider Business Mailing Address
First Line : 105 ARNOLD MILL RD
Second Line :
City : WOODSTOCK
State : GA
Zip : 30188-5027
Country : US
Telephone Number : 770-926-0016
Fax Number :
Provider Business Practice Location Address
First Line : 105 ARNOLD MILL RD
Second Line :
City : WOODSTOCK
State : GA
Zip : 30188-5027
Country : US
Telephone Number : 770-926-0016
Fax Number :
Authorized Official
Title or Position : CFO
Name : ISAAC OVITS
Credential :
Telephone Number : 845-694-6055
Provider Enumeration Date : 12/18/2013
Last Update Date : 01/19/2022

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Directions to “WOODSTOCK CYPRESS LLC ” Practice Location

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