Provider Demographics
NPI:1528387768
Name:CRNC OPERATING LLC.
Entity Type:Organization
Organization Name:CRNC OPERATING LLC.
Other - Org Name:CAMBRIDGE REHABILITATION AND NURSING CENTER
Other - Org Type:Doing Business As
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:MR
Authorized Official - First Name:EPHRAIM
Authorized Official - Middle Name:
Authorized Official - Last Name:ZAGELBAUM
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:914-597-7600
Mailing Address - Street 1:20 WOOD CT
Mailing Address - Street 2:
Mailing Address - City:TARRYTOWN
Mailing Address - State:NY
Mailing Address - Zip Code:10591-3108
Mailing Address - Country:US
Mailing Address - Phone:914-631-2600
Mailing Address - Fax:914-597-7622
Practice Address - Street 1:8 DANA ST
Practice Address - Street 2:
Practice Address - City:CAMBRIDGE
Practice Address - State:MA
Practice Address - Zip Code:02138-5402
Practice Address - Country:US
Practice Address - Phone:617-864-4267
Practice Address - Fax:914-597-7622
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2010-05-27
Last Update Date:2010-11-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MA314000000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes314000000XNursing & Custodial Care FacilitiesSkilled Nursing Facility
Provider Identifiers
StateIdentifier IDID TypeIssuer
MA0911542Medicaid
MA225520Medicare Oscar/Certification