Provider Demographics
NPI:1184944100
Name:CUMBERLAND BEHAVIOR GROUP, LLC
Entity type:Organization
Organization Name:CUMBERLAND BEHAVIOR GROUP, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:EXECUTIVE DIRECTOR
Authorized Official - Prefix:MR
Authorized Official - First Name:ACE
Authorized Official - Middle Name:ROBERT
Authorized Official - Last Name:JONES
Authorized Official - Suffix:II
Authorized Official - Credentials:
Authorized Official - Phone:606-416-6112
Mailing Address - Street 1:889 HIDEAWAY DR
Mailing Address - Street 2:
Mailing Address - City:SOMERSET
Mailing Address - State:KY
Mailing Address - Zip Code:42503
Mailing Address - Country:US
Mailing Address - Phone:606-416-6112
Mailing Address - Fax:
Practice Address - Street 1:889 HIDEAWAY DR
Practice Address - Street 2:
Practice Address - City:SOMERSET
Practice Address - State:KY
Practice Address - Zip Code:42503
Practice Address - Country:US
Practice Address - Phone:606-416-6112
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2010-06-02
Last Update Date:2011-08-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251S00000XAgenciesCommunity/Behavioral Health
No251B00000XAgenciesCase Management
No320900000XResidential Treatment FacilitiesCommunity Based Residential Treatment Facility, Intellectual and/or Developmental Disabilities