Provider Demographics
NPI:1467058958
Name:CAMBRIDGE PLACE ASSISTED LIVING AND MEMORY CARE
Entity Type:Organization
Organization Name:CAMBRIDGE PLACE ASSISTED LIVING AND MEMORY CARE
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:EXECUTIVE DIRECTOR
Authorized Official - Prefix:
Authorized Official - First Name:DAWN
Authorized Official - Middle Name:
Authorized Official - Last Name:ZORNES
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:740-255-5005
Mailing Address - Street 1:1480 DEERPATH DR
Mailing Address - Street 2:
Mailing Address - City:CAMBRIDGE
Mailing Address - State:OH
Mailing Address - Zip Code:43725-9098
Mailing Address - Country:US
Mailing Address - Phone:740-255-5005
Mailing Address - Fax:740-255-5785
Practice Address - Street 1:1480 DEERPATH DR
Practice Address - Street 2:
Practice Address - City:CAMBRIDGE
Practice Address - State:OH
Practice Address - Zip Code:43725-9098
Practice Address - Country:US
Practice Address - Phone:174-025-5500
Practice Address - Fax:740-255-5785
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2020-12-09
Last Update Date:2020-12-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes310400000XNursing & Custodial Care FacilitiesAssisted Living Facility
Provider Identifiers
StateIdentifier IDID TypeIssuer
OH533374544Medicaid