Healthcare Provider Details

I. General information

NPI: 1053928085
Provider Name (Legal Business Name): CUMBERLAND HOSPITAL LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 09/24/2020
Last Update Date: 05/25/2021
Certification Date: 05/25/2021
Deactivation Date:
Reactivation Date:

III. Provider practice location address

9407 CUMBERLAND RD
NEW KENT VA
23124-2029
US

IV. Provider business mailing address

9407 CUMBERLAND RD
NEW KENT VA
23124-2029
US

V. Phone/Fax

Practice location:
  • Phone: 804-966-2242
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code2084P0804X
TaxonomyChild & Adolescent Psychiatry Physician
License Number
License Number State
# 2
Primary TaxonomyY
Taxonomy Code273R00000X
TaxonomyPsychiatric Hospital Unit
License Number
License Number State

VIII. Authorized Official

Name: STEVE FILTON
Title or Position: VICE PRESIDENT
Credential:
Phone: 610-768-3482