MEDICARE: CYPRESS PLACE

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
1	251C00000X	Developmentally Disabled Services Day Training Agency

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1891962130
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	CYPRESS PLACE

Provider Business Mailing Address
First Line	:	2560 N STATE ROAD 7
Second Line	:
City	:	HOLLYWOOD
State	:	FL
Zip	:	33021-3205
Country	:	US
Telephone Number	:	957-989-7677
Fax Number	:	954-989-8977

Provider Business Practice Location Address
First Line	:	2560 N STATE ROAD 7
Second Line	:
City	:	HOLLYWOOD
State	:	FL
Zip	:	33021-3205
Country	:	US
Telephone Number	:	957-989-7677
Fax Number	:	954-989-8977

Authorized Official
Title or Position	:	DIRECTOR
Name	:	MRS. YVONNE GINSBERG
Credential	:
Telephone Number	:	954-989-7677

Provider Enumeration Date	:	05/15/2008
Last Update Date	:	05/15/2008

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Directions to “CYPRESS PLACE ” Practice Location

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