Organization
HP CAMBRIDGE HOUSE INC
Active
Other names
The Cambridge House
Organization subpart
No
Provider details
NPI number
Authorized official
DOUGLAS K MITTLEIDER (PRESIDENT)
(770) 619-0866
Entity
Organization
Contact information
Practice address
250 BELLEBROOK ROAD, BRISTOL, TN 37620-5623
(423) 968-4123
(423) 968-4076
Mailing address
5895 WINDWARD PKWY, SUITE 200, ALPHARETTA, GA 30005-5203
(770) 619-0866
(770) 870-2892
Taxonomy
Speciality
Code
Description
License number
State
314000000X
Skilled Nursing Facility
Primary
262
TN
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
0445190
—
TN
Enumeration date
07/09/2006
Last updated
05/25/2010
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