Whalio Doctors

NPI 1700941721

Frontier Health

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

Practice location

Address
2017 Stonebrook Pl, Kingsport, TN 37660-4000
Phone
(423) 224-1417
Fax
(423) 224-1418
Mailing address
PO Box 9054, Gray, TN 37615-9054

Authorised official

Name
Kristie Hammonds
Title
President and Ceo
Phone
(423) 467-3600

Registered specialties (2)

Intellectual and/or Developmental Disabilities Community Based Residential Treatment Facility Primary
Residential Treatment Facilities Taxonomy 320900000X Licence L 3(20)24M3-076-1414 (TN)
Developmentally Disabled Services Day Training Agency
Agencies Taxonomy 251C00000X Licence L 3(20)24M3-076-1414 (TN)

Registry record

NPI
1700941721
Entity type
Organization
NPI issued
27 Dec 2006
Record last updated
10 Jan 2020

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.