Healthcare Provider Details

I. General information

NPI: 1366532889
Provider Name (Legal Business Name): CEDAR SENIOR SERVICES LP
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 10/13/2006
Last Update Date: 08/22/2020
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

710 HIGHWAY 55
CAMP WOOD TX
78833-0830
US

IV. Provider business mailing address

710 HIGHWAY 55
CAMP WOOD TX
78833-0830
US

V. Phone/Fax

Practice location:
  • Phone: 830-597-5445
  • Fax: 830-597-5361
Mailing address:
  • Phone: 830-597-5445
  • Fax: 830-597-5361

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code314000000X
TaxonomySkilled Nursing Facility
License Number118576
License Number StateTX

VIII. Authorized Official

Name: TAMARA D SCOTCH
Title or Position: PARTNER
Credential:
Phone: 830-597-5445