NPI 1417197153

Frontier Health

Organisation Intellectual and/or Developmental Disabilities Community Based Residential Treatment Facility Johnson City, TN

Practice location

Address: 1113 King Springs Rd, Johnson City, TN 37601-5009
Phone: (423) 928-4802
Fax: (423) 467-3644
Mailing address: 1167 Spratlin Park Dr, Gray, TN 37615-6205

Authorised official

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

Registered specialties

Intellectual and/or Developmental Disabilities Community Based Residential Treatment Facility Primary

Residential Treatment Facilities Taxonomy 320900000X Licence L000000002500 (TN)

Other Community Based Residential Treatment Facility, Intellectual and/or Developmental Disabilities providers in Tennessee →

Registry record

NPI: 1417197153
Entity type: Organization
NPI issued: 20 Feb 2009
Record last updated: 20 Feb 2009

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.