Healthcare Provider Details

I. General information

NPI: 1114858974
Provider Name (Legal Business Name): MID-CUMBERLAND HUMAN RESOURCE AGENCY
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 05/28/2026
Last Update Date: 05/28/2026
Certification Date: 05/19/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

100 APRES' CROSSING
BURNS TN
37029
US

IV. Provider business mailing address

25 CENTURY BLVD BLDG STE 500
NASHVILLE TN
37214-3601
US

V. Phone/Fax

Practice location:
  • Phone: 615-347-0989
  • Fax: 615-834-8776
Mailing address:
  • Phone: 615-331-6033
  • Fax: 615-834-8776

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code261QR0405X
TaxonomySubstance Use Disorder Rehabilitation Clinic/Center
License Number
License Number State

VIII. Authorized Official

Name: JOHN KEVIN RYE
Title or Position: CFO
Credential: CPA
Phone: 615-850-3925