Healthcare Provider Details
I. General information
NPI: 1871507699
Provider Name (Legal Business Name): CUMBERLAND HOSPITAL LLC
Entity Type: Organization
Gender:
Sole Proprietor:
II. Dates (important events)
Enumeration Date: 07/28/2006
Last Update Date: 06/02/2023
Certification Date: 06/02/2023
Deactivation Date:
Reactivation Date:
III. Provider practice location address
9407 CUMBERLAND ROAD
NEW KENT VA
23124-9407
US
IV. Provider business mailing address
9407 CUMBERLAND ROAD
NEW KENT VA
23124-2029
US
V. Phone/Fax
- Phone: 804-966-2242
- Fax: 804-966-1643
- Phone: 804-966-2242
- Fax: 804-966-1643
VI. Provider taxonomy
Scope of Practice (Provider specialty)
| # 1 | |
| Primary Taxonomy | N |
| Taxonomy Code | 208000000X |
| Taxonomy | Pediatrics Physician |
| License Number | |
| License Number State | |
| # 2 | |
| Primary Taxonomy | N |
| Taxonomy Code | 2084P0804X |
| Taxonomy | Child & Adolescent Psychiatry Physician |
| License Number | |
| License Number State | |
| # 3 | |
| Primary Taxonomy | N |
| Taxonomy Code | 273R00000X |
| Taxonomy | Psychiatric Hospital Unit |
| License Number | |
| License Number State | |
| # 4 | |
| Primary Taxonomy | N |
| Taxonomy Code | 320600000X |
| Taxonomy | Intellectual and/or Developmental Disabilities Residential Treatment Facility |
| License Number | |
| License Number State | |
| # 5 | |
| Primary Taxonomy | N |
| Taxonomy Code | 363L00000X |
| Taxonomy | Nurse Practitioner |
| License Number | |
| License Number State | |
| # 6 | |
| Primary Taxonomy | N |
| Taxonomy Code | 363LF0000X |
| Taxonomy | Family Nurse Practitioner |
| License Number | |
| License Number State | |
| # 7 | |
| Primary Taxonomy | N |
| Taxonomy Code | 363LP0200X |
| Taxonomy | Pediatric Nurse Practitioner |
| License Number | |
| License Number State | |
| # 8 | |
| Primary Taxonomy | Y |
| Taxonomy Code | 282N00000X |
| Taxonomy | General Acute Care Hospital |
| License Number | |
| License Number State | |
VIII. Authorized Official
Name:
STEVE
FILTON
Title or Position: SRVPCFO
Credential:
Phone: 610-768-3300