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General NPI Number Information
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NPI Number | 1649336173
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Entity Type | Organization
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Legal Business Name | FRONTIER HEALTH
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Dates
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Enumeration Date | 12/29/2006
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Last Update Date | 11/26/2024
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Provider Practice Location Address
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Address Line | 295 WHARTON LANE
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City | NORTON
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State | VA
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Zip | 24273-1541
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Country | US
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Telephone | 276-523-8300
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Fax | 276-523-6964
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Provider Business Mailing Address
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Address Line | 1167 SPRATLIN PARK DR
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City | GRAY
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State | TN
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Zip | 37615-6205
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Country | US
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Telephone | 423-467-3600
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Fax | 423-467-3644
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Authorized Official
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Title or Position | DIRECTOR OF CONTRACTING/ COMPLIANCE
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Name | CRISTI LYNN BLALOCK
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Credential | BS
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Telephone | 423-467-3741
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 251B00000X
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Taxonomy Name | Case Management Agency
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License Number | 315-16-001
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License Number State | VA
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Taxonomy #2
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Taxonomy Code | 251S00000X
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Taxonomy Name | Community/Behavioral Health Agency
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License Number | 315-07-004
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License Number State | VA
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Taxonomy #3
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Taxonomy Code | 261QR0405X
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Taxonomy Name | Substance Use Disorder Rehabilitation Clinic/Center
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License Number | 315-07-004
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License Number State | VA
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Taxonomy #4
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Taxonomy Code | 385H00000X
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Taxonomy Name | Respite Care
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License Number | 315-03-001
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License Number State | VA
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Taxonomy #5
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Taxonomy Code | 261QM0801X
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Taxonomy Name | Mental Health Clinic/Center (Including Community Mental Health Center)
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License Number | 315-07-004
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License Number State | VA
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