Healthcare Provider Details

I. General information

NPI: 1801847132
Provider Name (Legal Business Name): GGNSC CAMBRIDGE SPRINGS LP
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 05/12/2006
Last Update Date: 08/22/2020
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

110 CANFIELD ST
CAMBRIDGE SPRINGS PA
16403-1108
US

IV. Provider business mailing address

110 CANFIELD ST
CAMBRIDGE SPRINGS PA
16403-1108
US

V. Phone/Fax

Practice location:
  • Phone: 814-398-4626
  • Fax: 814-398-2803
Mailing address:
  • Phone: 814-398-4626
  • Fax: 814-398-2803

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code314000000X
TaxonomySkilled Nursing Facility
License Number191902
License Number StatePA

VIII. Authorized Official

Name: HOLLY A. RASMUSSEN-JONES
Title or Position: SEC. OF THE GP
Credential:
Phone: 479-201-4835