Provider Demographics
NPI:1699077297
Name:CAMBRIDGE HEALTH ALLIANCE
Entity type:Organization
Organization Name:CAMBRIDGE HEALTH ALLIANCE
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:STAFF NURSE
Authorized Official - Prefix:MRS
Authorized Official - First Name:RENEE
Authorized Official - Middle Name:MAUDE
Authorized Official - Last Name:GUERRIER
Authorized Official - Suffix:
Authorized Official - Credentials:RN
Authorized Official - Phone:781-322-2930
Mailing Address - Street 1:39 KNOLLIN ST
Mailing Address - Street 2:
Mailing Address - City:MALDEN
Mailing Address - State:MA
Mailing Address - Zip Code:02148-2953
Mailing Address - Country:US
Mailing Address - Phone:781-322-2930
Mailing Address - Fax:
Practice Address - Street 1:39 KNOLLIN ST
Practice Address - Street 2:
Practice Address - City:MALDEN
Practice Address - State:MA
Practice Address - Zip Code:02148-2953
Practice Address - Country:US
Practice Address - Phone:781-322-2930
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2010-12-02
Last Update Date:2010-12-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MA267683261QA0600X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QA0600XAmbulatory Health Care FacilitiesClinic/CenterAdult Day Care