CUMBERLAND RIVER BEHAVIORAL HEALTH, INC

Provider Demographics

• NPI: 1902023526
• Name: CUMBERLAND RIVER BEHAVIORAL HEALTH, INC
• Entity Type: Organization
• Organization Name: CUMBERLAND RIVER BEHAVIORAL HEALTH, INC
• Other - Org Name: CUMBERLAND RIVER COMPREHENSIVE CARE CENTER
• Other - Org Type: Other Name
• Authorized Official - Title/Position: CEO
• Authorized Official - First Name: MELANIE
• Authorized Official - Last Name: YEAGER
• Authorized Official - Phone: 606-528-7010
• Mailing Address - Street 1: PO BOX 568
• Mailing Address - City: CORBIN
• Mailing Address - State: KY
• Mailing Address - Zip Code: 40702-0568
• Mailing Address - Country: US
• Mailing Address - Phone: 606-528-7010
• Mailing Address - Fax: 606-528-5401
• Practice Address - Street 1: 1203 AMERICAN GREETING RD
• Practice Address - City: CORBIN
• Practice Address - State: KY
• Practice Address - Zip Code: 40701-4811
• Practice Address - Country: US
• Practice Address - Phone: 606-528-7010
• Practice Address - Fax: 606-528-5401
• EIN: <UNAVAIL>
• Is Organization Subpart?: No
• Enumeration Date: 2007-04-18
• Last Update Date: 2020-08-19

Provider Taxonomies

Primary?	Code	Type	Classification	Specialization
Yes	251S00000X	Agencies	Community/Behavioral Health
No	251C00000X	Agencies	Day Training, Developmentally Disabled Services
No	261QH0100X	Ambulatory Health Care Facilities	Clinic/Center	Health Service
No	261QM0801X	Ambulatory Health Care Facilities	Clinic/Center	Mental Health (Including Community Mental Health Center)
No	261QM0850X	Ambulatory Health Care Facilities	Clinic/Center	Adult Mental Health
No	261QM0855X	Ambulatory Health Care Facilities	Clinic/Center	Adolescent and Children Mental Health

Provider Identifiers

State	Identifier ID	ID Type	Issuer
KY	45305554	Medicaid
KY	33900051	Medicaid
KY	17000696	Medicaid
KY	30613038	Medicaid
KY	27013010	Medicaid
KY	28013019	Medicaid
KY	17000696	Medicaid
KY	3544	Medicare ID - Type Unspecified	BENHAM
KY	30613038	Medicaid
KY	45305554	Medicaid
KY	3557	Medicare ID - Type Unspecified	MCKEE
KY	3542	Medicare ID - Type Unspecified	BARBOURVILLE
KY	7538	Medicare ID - Type Unspecified	HAVEN HOUSE
KY	3541	Medicare ID - Type Unspecified	MT VERNON
KY	3545	Medicare ID - Type Unspecified	MANCHESTER
KY	33900051	Medicaid
KY	27013010	Medicaid
KY	2956	Medicare ID - Type Unspecified	PINEVILLE