Provider Demographics
NPI:1508923061
Name:CAMBRIDGE DEVELOPMENTAL CENTER
Entity Type:Organization
Organization Name:CAMBRIDGE DEVELOPMENTAL CENTER
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:SUPERINTENDENT
Authorized Official - Prefix:MRS
Authorized Official - First Name:CATHLEEN
Authorized Official - Middle Name:
Authorized Official - Last Name:BALLINGER
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:740-439-1371
Mailing Address - Street 1:66737 TOLAND DR
Mailing Address - Street 2:
Mailing Address - City:CAMBRIDGE
Mailing Address - State:OH
Mailing Address - Zip Code:43725-1155
Mailing Address - Country:US
Mailing Address - Phone:740-439-1371
Mailing Address - Fax:740-439-4382
Practice Address - Street 1:66737 TOLAND DR
Practice Address - Street 2:
Practice Address - City:CAMBRIDGE
Practice Address - State:OH
Practice Address - Zip Code:43725-1155
Practice Address - Country:US
Practice Address - Phone:740-439-1371
Practice Address - Fax:740-439-4382
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:STATE OF OHIO OFFICE OF BUDGET AND MANAGEMENT STATE ACCOUNTING
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2007-01-03
Last Update Date:2015-10-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH320600000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes320600000XResidential Treatment FacilitiesResidential Treatment Facility, Intellectual and/or Developmental Disabilities
Provider Identifiers
StateIdentifier IDID TypeIssuer
OH2396116Medicaid
OH2396116Medicaid