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General NPI Number Information
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NPI Number | 1730245010
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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 | 08/11/2025
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Provider Practice Location Address
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Address Line | 2243 EDDIE WILLIAMS RD
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City | JOHNSON CITY
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State | TN
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Zip | 37601-2872
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Country | US
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Telephone | 423-928-5627
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Fax | 423-928-4222
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Provider Business Mailing Address
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Address Line | PO BOX 9054
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City | GRAY
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State | TN
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Zip | 37615-9054
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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 | DIR. CONTRACTING/COMPLIANCE
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Name | DR. CRISTI L BLALOCK
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Credential | MBA
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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 | 261QM0850X
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Taxonomy Name | Adult Mental Health Clinic/Center
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License Number | L 229-076-1429
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License Number State | TN
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Taxonomy #2
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Taxonomy Code | 261QR0400X
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Taxonomy Name | Rehabilitation Clinic/Center
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License Number |
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License Number State |
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