Provider Demographics
NPI:1164549952
Name:CAMBRIDGE COURT ASSISTED LIVING LIMITED PARTNERSHIP
Entity Type:Organization
Organization Name:CAMBRIDGE COURT ASSISTED LIVING LIMITED PARTNERSHIP
Other - Org Name:CAMBRIDGE COURT ASSISTED LIVING AND MEMORY CARE COMMUNITY
Other - Org Type:Doing Business As
Authorized Official - Title/Position:MANAGER
Authorized Official - Prefix:MR
Authorized Official - First Name:JON
Authorized Official - Middle Name:M
Authorized Official - Last Name:HARDER
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:503-375-9016
Mailing Address - Street 1:PO BOX 3006
Mailing Address - Street 2:
Mailing Address - City:SALEM
Mailing Address - State:OR
Mailing Address - Zip Code:97302-0006
Mailing Address - Country:US
Mailing Address - Phone:503-485-4600
Mailing Address - Fax:503-485-1279
Practice Address - Street 1:711 MATADOR LN
Practice Address - Street 2:
Practice Address - City:MESQUITE
Practice Address - State:TX
Practice Address - Zip Code:75149-8830
Practice Address - Country:US
Practice Address - Phone:972-285-9800
Practice Address - Fax:503-485-1279
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-03-25
Last Update Date:2008-07-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes311500000XNursing & Custodial Care FacilitiesAlzheimer Center (Dementia Center)
No310400000XNursing & Custodial Care FacilitiesAssisted Living Facility