Healthcare Provider Details

I. General information

NPI: 1598102089
Provider Name (Legal Business Name): CUMBERLAND HEALTH AND WELLNESS GROUP
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 05/24/2013
Last Update Date: 12/09/2013
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

88 LAFAYETTE ST
NASHVILLE TN
37210-3433
US

IV. Provider business mailing address

88 LAFAYETTE ST
NASHVILLE TN
37210-3433
US

V. Phone/Fax

Practice location:
  • Phone: 615-281-9652
  • Fax:
Mailing address:
  • Phone: 615-281-9652
  • Fax: 615-523-1229

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code251B00000X
TaxonomyCase Management Agency
License Number1000000013495
License Number StateTN
# 2
Primary TaxonomyN
Taxonomy Code251S00000X
TaxonomyCommunity/Behavioral Health Agency
License Number1000000013495
License Number StateTN

VIII. Authorized Official

Name: MR. WILL WYATT
Title or Position: DIRECTOR
Credential:
Phone: 615-281-9652