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General NPI Number Information
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NPI Number | 1811053341
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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 | 06/05/2025
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Provider Practice Location Address
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Address Line | 900 BUFFALO ST
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City | JOHNSON CITY
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State | TN
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Zip | 37604-6720
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Country | US
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Telephone | 423-461-7750
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Fax | 423-467-3644
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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 | DIRECTOR OF CONTRACTING/ COMPLIANCE
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Name | CRISTI LYNN 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 | 324500000X
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Taxonomy Name | Substance Abuse Rehabilitation Facility
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License Number |
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License Number State |
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