Organization
MID CUMBERLAND COMMUNITY SERVICES AGENCY
Active
Organization subpart
No
Provider details
NPI number
Authorized official
BEVERLY G BASS (EXECUTIVE DIRECTOR)
(615) 333-5450
Entity
Organization
Contact information
Practice address
531 METROPLEX DR STE 200A, NASHVILLE, TN 37211-3169
(616) 333-5400
Mailing address
531 METROPLEX DR STE 200A, NASHVILLE, TN 37211-3169
(616) 333-5400
Taxonomy
Speciality
Code
Description
License number
State
347E00000X
Transportation Broker
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
T000206
—
TN
Enumeration date
01/22/2007
Last updated
08/22/2020
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