Provider Demographics
NPI:1316220247
Name:CAMBRIDGE SIERRA HOLDINGS LLC
Entity Type:Organization
Organization Name:CAMBRIDGE SIERRA HOLDINGS LLC
Other - Org Name:RECHE COUNTY REGIONAL REHAB
Other - Org Type:Doing Business As
Authorized Official - Title/Position:CFO
Authorized Official - Prefix:MS
Authorized Official - First Name:LYNDA
Authorized Official - Middle Name:S
Authorized Official - Last Name:HEBBELN
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:727-723-3021
Mailing Address - Street 1:1350 RECHE CANYON RD
Mailing Address - Street 2:
Mailing Address - City:COLTON
Mailing Address - State:CA
Mailing Address - Zip Code:92324-9528
Mailing Address - Country:US
Mailing Address - Phone:909-370-4411
Mailing Address - Fax:909-370-1846
Practice Address - Street 1:1350 RECHE CANYON RD
Practice Address - Street 2:
Practice Address - City:COLTON
Practice Address - State:CA
Practice Address - Zip Code:92324-9528
Practice Address - Country:US
Practice Address - Phone:909-370-4411
Practice Address - Fax:909-370-1846
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2011-09-27
Last Update Date:2014-02-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA314000000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes314000000XNursing & Custodial Care FacilitiesSkilled Nursing Facility
Provider Identifiers
StateIdentifier IDID TypeIssuer
CA555435Medicare Oscar/Certification