Provider Demographics
NPI:1124766332
Name:CUMBERLAND RESIDENTIAL CARE LLC
Entity type:Organization
Organization Name:CUMBERLAND RESIDENTIAL CARE LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:YANNICK
Authorized Official - Middle Name:
Authorized Official - Last Name:NDAYISENGA
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:607-232-0419
Mailing Address - Street 1:94 1/2 BOWERS ST
Mailing Address - Street 2:
Mailing Address - City:NASHUA
Mailing Address - State:NH
Mailing Address - Zip Code:03060-6365
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:94 1/2 BOWERS ST
Practice Address - Street 2:
Practice Address - City:NASHUA
Practice Address - State:NH
Practice Address - Zip Code:03060-6365
Practice Address - Country:US
Practice Address - Phone:607-232-0419
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2022-05-26
Last Update Date:2022-05-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes320900000XResidential Treatment FacilitiesCommunity Based Residential Treatment Facility, Intellectual and/or Developmental Disabilities