Basic Information
| Provider Information | |||||||||
| NPI: | 1891334405 | ||||||||
| EntityType: | 2 | ||||||||
| ReplacementNPI: | |||||||||
| OrganizationName: | CAMBRIDGE OPERATOR LLC | ||||||||
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| Mailing Information | |||||||||
| Address1: | 255 E MAIN ST | ||||||||
| Address2: | |||||||||
| City: | MOORESTOWN | ||||||||
| State: | NJ | ||||||||
| PostalCode: | 080572982 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 7329031958 | ||||||||
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| Practice Location | |||||||||
| Address1: | 255 E MAIN ST | ||||||||
| Address2: | |||||||||
| City: | MOORESTOWN | ||||||||
| State: | NJ | ||||||||
| PostalCode: | 080572982 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 7329031958 | ||||||||
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| Other Information | |||||||||
| ProviderEnumerationDate: | 12/30/2019 | ||||||||
| LastUpdateDate: | 12/30/2019 | ||||||||
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| AuthorizedOfficialLastName: | ROKOWSKY | ||||||||
| AuthorizedOfficialFirstName: | YITZCHOK | ||||||||
| AuthorizedOfficialMiddleName: | |||||||||
| AuthorizedOfficialTitleorPosition: | PRINCIPLE | ||||||||
| AuthorizedOfficialTelephone: | 7329031958 | ||||||||
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| IsOrganizationSubpart: | N | ||||||||
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| NPICertificationDate: | 12/30/2019 | ||||||||
Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 314000000X | Y | Nursing & Custodial Care Facilities | Skilled Nursing Facility |
No ID Information.