Provider Demographics
NPI:1508863986
Name:CAMBRIDGE HEALTH ALLIANCE ELDER SERVICE PLAN
Entity Type:Organization
Organization Name:CAMBRIDGE HEALTH ALLIANCE ELDER SERVICE PLAN
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:ASSOCIATE EXECUTIVE DIRECTOR
Authorized Official - Prefix:
Authorized Official - First Name:CAROL
Authorized Official - Middle Name:
Authorized Official - Last Name:MURPHY
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:781-306-8666
Mailing Address - Street 1:270 GREEN ST
Mailing Address - Street 2:
Mailing Address - City:CAMBRIDGE
Mailing Address - State:MA
Mailing Address - Zip Code:02139-3312
Mailing Address - Country:US
Mailing Address - Phone:781-306-8666
Mailing Address - Fax:781-306-8660
Practice Address - Street 1:270 GREEN ST
Practice Address - Street 2:
Practice Address - City:CAMBRIDGE
Practice Address - State:MA
Practice Address - Zip Code:02139-3312
Practice Address - Country:US
Practice Address - Phone:781-306-8666
Practice Address - Fax:781-306-8660
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2005-06-30
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MA302F00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes302F00000XManaged Care OrganizationsExclusive Provider Organization