Organization
CUMBERLAND RESIDENTIAL CARE LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
YANNICK NDAYISENGA (CEO)
(607) 232-0419
Entity
Organization
Contact information
Practice address
2566 E CALLE TOBO, TUCSON, AZ 85706-0048
(607) 232-0419
Mailing address
2566 E CALLE TOBO, TUCSON, AZ 85706-0048
(607) 232-0419
Taxonomy
Speciality
Code
Description
License number
State
251E00000X
Home Health Agency
—
—
320900000X
Intellectual and/or Developmental Disabilities Community Based Residential Treatment Facility
Primary
—
—
Other
Enumeration date
09/07/2021
Last updated
09/07/2021
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