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NPI Code Detail

MEDICARE: EMBASSY CAMBRIDGE, LLC

MEDICARE: EMBASSY CAMBRIDGE, LLC
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
1314000000XSkilled Nursing Facility

Other Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
11582NOTHEROHLICENSURE

General Provider Information

NPI Number : 1265066054
Entity Type Code : Organization
Provider Name (Legal Business Name) : EMBASSY CAMBRIDGE, LLC
Provider Business Mailing Address
First Line : 25201 CHAGRIN BLVD STE 190
Second Line :
City : BEACHWOOD
State : OH
Zip : 44122-5633
Country : US
Telephone Number : 216-378-2050
Fax Number :
Provider Business Practice Location Address
First Line : 1471 WILLS CREEK VALLEY DR
Second Line :
City : CAMBRIDGE
State : OH
Zip : 43725-8620
Country : US
Telephone Number : 740-439-4437
Fax Number :
Authorized Official
Title or Position : ATTORNEY
Name : HAYLEY WILLIAMS
Credential :
Telephone Number : 216-706-3936
Provider Enumeration Date : 03/02/2020
Last Update Date : 03/02/2020

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Directions to “EMBASSY CAMBRIDGE, LLC ” Practice Location

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