LP Cambridge LLC

Primary specialty

Skilled Nursing FacilityTaxonomy code 314000000X

License

09-006 Issued in MD

Legal business name

LP CAMBRIDGE LLC

Doing business as

Signature HealthCARE at Mallard Bay

Practice address

520 Glenburn Ave
Cambridge, MD 21613-1415

Phone

(410) 228-9191

Fax

(410) 228-8350

NPI assigned

Aug 5, 2007

Last updated

Sep 2, 2022By the provider in NPPES

Organization subpart

Yes

Parent organization

LP CS HOLDINGS LLCAs reported in NPPES

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name

Mr. John Harrison

Title

Cfo

Phone

(561) 627-0664

Specialties & licenses 1

Addresses

Other names 1

• Signature HealthCARE at Mallard Bay Doing business as

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1186272000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1662076800000",
    "number": "1114118494",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "12201 BLUEGRASS PKWY",
            "city": "LOUISVILLE",
            "state": "KY",
            "postal_code": "402992361",
            "telephone_number": "502-568-7800"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "520 GLENBURN AVE",
            "city": "CAMBRIDGE",
            "state": "MD",
            "postal_code": "216131415",
            "telephone_number": "410-228-9191",
            "fax_number": "410-228-8350"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "LP CAMBRIDGE LLC",
        "organizational_subpart": "YES",
        "parent_organization_legal_business_name": "LP CS HOLDINGS LLC",
        "enumeration_date": "2007-08-05",
        "last_updated": "2022-09-02",
        "certification_date": "2022-09-02",
        "status": "A",
        "authorized_official_last_name": "HARRISON",
        "authorized_official_first_name": "JOHN",
        "authorized_official_title_or_position": "CFO",
        "authorized_official_telephone_number": "561-627-0664",
        "authorized_official_name_prefix": "Mr."
    },
    "taxonomies": [
        {
            "code": "314000000X",
            "taxonomy_group": "",
            "desc": "Skilled Nursing Facility",
            "state": "MD",
            "license": "09-006",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Signature HealthCARE at Mallard Bay",
            "code": "3",
            "type": "Doing Business As"
        },
        {
            "organization_name": "Signature HealthCARE at Mallard Bay",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

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• Skilled Nursing Facility in Cambridge, MD
• Providers in Cambridge, MD by specialty
• Skilled Nursing Facility in Maryland

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 2, 2022; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.