Provider Demographics
NPI:1649311747
Name:CUMBERLAND ADULT DAY HEALTH CARE CENTER
Entity type:Organization
Organization Name:CUMBERLAND ADULT DAY HEALTH CARE CENTER
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:CYNTHIA
Authorized Official - Middle Name:D
Authorized Official - Last Name:PENNYCUFF
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:606-387-7073
Mailing Address - Street 1:RR 5 BOX 186
Mailing Address - Street 2:
Mailing Address - City:ALBANY
Mailing Address - State:KY
Mailing Address - Zip Code:42602-5529
Mailing Address - Country:US
Mailing Address - Phone:606-387-7073
Mailing Address - Fax:270-864-7175
Practice Address - Street 1:150 SHORT STREET
Practice Address - Street 2:
Practice Address - City:BURKESVILLE
Practice Address - State:KY
Practice Address - Zip Code:42717
Practice Address - Country:US
Practice Address - Phone:270-864-2254
Practice Address - Fax:270-864-7175
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-02-09
Last Update Date:2015-03-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QA0600XAmbulatory Health Care FacilitiesClinic/CenterAdult Day Care
Provider Identifiers
StateIdentifier IDID TypeIssuer
KY43000298Medicaid