NPI 1265632392

Frontier Health

Organisation Mental Illness Community Based Residential Treatment Facility Johnson City, TN

Practice location

Address: 516 Swadley Rd, Johnson City, TN 37601-9000
Phone: (423) 926-9001
Fax: (423) 232-2752
Mailing address: PO Box 9054, Gray, TN 37615-9054

Authorised official

Name: E Douglas Varney
Title: President and Ceo
Phone: (423) 467-3600

Registered specialties

Mental Illness Community Based Residential Treatment Facility Primary

Residential Treatment Facilities Taxonomy 320800000X Licence L 219-076-1421 (TN)

Other Community Based Residential Treatment Facility, Mental Illness providers in Tennessee →

Registry record

NPI: 1265632392
Entity type: Organization
NPI issued: 18 Jul 2007
Record last updated: 18 Jul 2007

Reproduced from NPPES, the federal provider registry. The date above is when the provider last updated their own entry, not when we fetched it - a record can be years old and still current in the registry.