Organization
UPPER CUMBERLAND COMMUNITY SERVICES AGENCY
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MRS. SUE ANN PILSON (EXECUTIVE DIRECTOR)
(931) 520-0200
Entity
Organization
Contact information
Practice address
1000 ENGLAND DR, SUITE F, COOKEVILLE, TN 38501-0940
(931) 520-0200
(931) 520-0080
Mailing address
1000 ENGLAND DR, SUITE F, COOKEVILLE, TN 38501-0940
(931) 520-0200
(931) 520-0080
Taxonomy
Speciality
Code
Description
License number
State
251B00000X
Case Management Agency
Primary
—
—
347E00000X
Transportation Broker
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
T000196
TENNCARE/MEDICAID
TN
Enumeration date
08/15/2007
Last updated
08/15/2007
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