Provider Demographics
NPI:1063655272
Name:CYPRESS HEALTH CARE INC.
Entity Type:Organization
Organization Name:CYPRESS HEALTH CARE INC.
Other - Org Name:ATHENS HEALTHCARE AND REHABILITATION CENTER
Other - Org Type:Doing Business As
Authorized Official - Title/Position:PRES.
Authorized Official - Prefix:MR
Authorized Official - First Name:EMERY
Authorized Official - Middle Name:R
Authorized Official - Last Name:FISHER
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:512-288-9119
Mailing Address - Street 1:13110 W HWY 290 STE 103
Mailing Address - Street 2:
Mailing Address - City:AUSTIN
Mailing Address - State:TX
Mailing Address - Zip Code:78737-8500
Mailing Address - Country:US
Mailing Address - Phone:512-288-9123
Mailing Address - Fax:512-288-9120
Practice Address - Street 1:305 S PALESTINE ST
Practice Address - Street 2:
Practice Address - City:ATHENS
Practice Address - State:TX
Practice Address - Zip Code:75751-2509
Practice Address - Country:US
Practice Address - Phone:903-675-2046
Practice Address - Fax:903-675-2471
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2009-04-17
Last Update Date:2015-09-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX001-0170-22314000000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes314000000XNursing & Custodial Care FacilitiesSkilled Nursing Facility
Provider Identifiers
StateIdentifier IDID TypeIssuer
67-5264OtherMEDICARE PTAN
TX4009Medicaid