Healthcare Provider Details

I. General information

NPI: 1275945024
Provider Name (Legal Business Name): CAMBRIDGE HEALTHCARE
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 05/28/2014
Last Update Date: 05/28/2014
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

22960 SHAW RD STE 605
STERLING VA
20166-9447
US

IV. Provider business mailing address

301 CRICKLEWOOD SQ APT C
ASHEVILLE NC
28804-8210
US

V. Phone/Fax

Practice location:
  • Phone: 703-798-7506
  • Fax:
Mailing address:
  • Phone: 828-775-4790
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code314000000X
TaxonomySkilled Nursing Facility
License NumberOT13327
License Number StateFL

VIII. Authorized Official

Name: LAVANYE CHALLAPALLI
Title or Position: BUSINESS DEVELOPMENT MANAGER
Credential:
Phone: 703-798-7506