Cumberland Residential Care, LLC

Primary specialty

Psychiatric Residential Treatment FacilityTaxonomy code 323P00000X

Legal business name

CUMBERLAND RESIDENTIAL CARE, LLC

Practice address

2825 East Cottonwood Parkway
Suite 500
Cottonwood Heights, UT 84121

Phone

(207) 618-3784

NPI assigned

Dec 10, 2021

Last updated

Dec 10, 2021By the provider in NPPES

Organization subpart

No

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

Authorized official

Name

Yannick Ndayisega

Title

Ceo

Phone

(207) 618-3784

Specialties & licenses 1

Addresses

Other identifiers 1

Other names 1

• CUMBERLAND RESIDENTIAL CARE, LLC Other name

Electronic endpoints 1

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

{
    "created_epoch": "1639094400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1639094400000",
    "number": "1568121127",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2825 E COTTONWOOD PKWY STE 500",
            "city": "COTTONWOOD HEIGHTS",
            "state": "UT",
            "postal_code": "841217060",
            "telephone_number": "207-618-3784"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2825 EAST COTTONWOOD PARKWAY",
            "address_2": "SUITE 500",
            "city": "COTTONWOOD HEIGHTS",
            "state": "UT",
            "postal_code": "84121",
            "telephone_number": "207-618-3784"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "CUMBERLAND RESIDENTIAL CARE, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2021-12-10",
        "last_updated": "2021-12-10",
        "certification_date": "2021-11-25",
        "status": "A",
        "authorized_official_last_name": "NDAYISEGA",
        "authorized_official_first_name": "YANNICK",
        "authorized_official_title_or_position": "CEO",
        "authorized_official_telephone_number": "207-618-3784"
    },
    "taxonomies": [
        {
            "code": "323P00000X",
            "taxonomy_group": "",
            "desc": "Psychiatric Residential Treatment Facility",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1790454486",
            "state": "AZ"
        }
    ],
    "endpoints": [
        {
            "endpointType": "SOAP",
            "endpointTypeDescription": "SOAP URL",
            "endpoint": "Devices",
            "affiliation": "N",
            "endpointDescription": "Electronic devices",
            "use": "DIRECT",
            "useDescription": "Direct",
            "contentType": "CSV",
            "contentTypeDescription": "CSV",
            "contentOtherDescription": "Documents",
            "address_1": "2825 E Cottonwood Pkwy Ste 500",
            "city": "Cottonwood Heights",
            "state": "UT",
            "country_code": "US",
            "postal_code": "841217060",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": [
        {
            "organization_name": "CUMBERLAND RESIDENTIAL CARE, LLC",
            "code": "5",
            "type": "Other Name"
        }
    ]
}

• Jade Crager
• Cody Crane, DPT
• Ashleigh Creps, LCSW
• Laurie Dee Crookston, RN
• Priscilla Cueva
• Hannah Curnutt
• Maile Cutter
• Emma Dacosta
• Kensley Dalton
• Brianna Davis, LCSW

• Psychiatric Residential Treatment Facility in Cottonwood Heights, UT
• Providers in Cottonwood Heights, UT by specialty
• Psychiatric Residential Treatment Facility in Utah

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 10, 2021; 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.