Provider Demographics
NPI:1083749469
Name:CAMBRIDGE HOME HEALTH CARE, INC
Entity Type:Organization
Organization Name:CAMBRIDGE HOME HEALTH CARE, INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT CEO
Authorized Official - Prefix:MS
Authorized Official - First Name:NANCY
Authorized Official - Middle Name:J
Authorized Official - Last Name:DILLER SHIVELY
Authorized Official - Suffix:
Authorized Official - Credentials:RN
Authorized Official - Phone:330-668-1922
Mailing Address - Street 1:120 E HIGHLAND AVE
Mailing Address - Street 2:
Mailing Address - City:RAVENNA
Mailing Address - State:OH
Mailing Address - Zip Code:44266-2242
Mailing Address - Country:US
Mailing Address - Phone:330-297-9410
Mailing Address - Fax:330-297-9464
Practice Address - Street 1:120 E HIGHLAND AVE
Practice Address - Street 2:
Practice Address - City:RAVENNA
Practice Address - State:OH
Practice Address - Zip Code:44266-2242
Practice Address - Country:US
Practice Address - Phone:330-297-9410
Practice Address - Fax:330-297-9464
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:CAMBRIDGE HOME HEALTH CARE INC
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2007-02-23
Last Update Date:2009-01-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251E00000XAgenciesHome Health
Provider Identifiers
StateIdentifier IDID TypeIssuer
OH368163Medicare Oscar/Certification