NPIMap

Organization Active NPI

Cumberland Mountain Community Services

  • Substance Abuse Rehabilitation Facility
  • Lebanon, VA
National Provider Identifier
1093882003
Registry record updated Aug 22, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Substance Abuse Rehabilitation FacilityTaxonomy code 324500000X
License
09301006 Issued in VA
Legal business name
CUMBERLAND MOUNTAIN COMMUNITY SERVICES
Practice address
102 Kemp Street
Lebanon, VA 24266
Phone
(276) 889-3063
Fax
(276) 889-5005
NPI assigned
Nov 29, 2006
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Aug 22, 2020

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name
Mrs. Jane A Peay, LCSW
Title
Substance Abuse Director
Phone
(276) 964-6702

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Substance Abuse Rehabilitation Facility 324500000X 09301006 VA Primary

Addresses

Primary practice location

102 Kemp Street
Lebanon, VA 24266

Mailing address

PO Box 810
Cedar Bluff, VA 24609-0810
Phone (276) 889-3063

Other names 1

  • The Laurels Other name

National Provider Directory

National Provider Directory
Tax ID family
Cumberland Mountain Community Services3 organizations share this tax ID, including this one

Other organizations with this tax ID 2

Organizations that report the same tax identification number in the National Provider Directory.

Interoperability endpoints

  • FHIR API: https://fhir-myrecord.cerner.com/r4/bf94e4d0-3a14-41fb-bd44-4abbe957f297/

Practitioners & affiliated clinicians

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1164758400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1598054400000",
    "number": "1093882003",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 810",
            "city": "CEDAR BLUFF",
            "state": "VA",
            "postal_code": "246090810",
            "telephone_number": "276-889-3063",
            "fax_number": "276-889-5005"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "102 KEMP STREET",
            "city": "LEBANON",
            "state": "VA",
            "postal_code": "24266",
            "telephone_number": "276-889-3063",
            "fax_number": "276-889-5005"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "CUMBERLAND MOUNTAIN COMMUNITY SERVICES",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-11-29",
        "last_updated": "2020-08-22",
        "status": "A",
        "authorized_official_last_name": "PEAY",
        "authorized_official_first_name": "JANE",
        "authorized_official_middle_name": "A",
        "authorized_official_title_or_position": "SUBSTANCE ABUSE DIRECTOR",
        "authorized_official_telephone_number": "276-964-6702",
        "authorized_official_name_prefix": "Mrs.",
        "authorized_official_credential": "LCSW"
    },
    "taxonomies": [
        {
            "code": "324500000X",
            "taxonomy_group": "",
            "desc": "Substance Abuse Rehabilitation Facility",
            "state": "VA",
            "license": "09301006",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "The Laurels",
            "code": "5",
            "type": "Other Name"
        }
    ]
}

Other providers in Lebanon, VA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 22, 2020; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.