Organization · Type 2 NPI
Frontier Health
Intellectual and/or Developmental Disabilities Community Based Residential Treatment Facility · Johnson City, TN
Practice location
1113 King Springs Rd
Johnson City, TN 37601-5009
Fax (423) 467-3644
Mailing address
1167 Spratlin Park Dr
Gray, TN 37615-6205
Specialties and licenses
| Taxonomy | Code | License |
|---|---|---|
| Intellectual and/or Developmental Disabilities Community Based Residential Treatment Facility Primary | 320900000X | L000000002500 (TN) |
Intellectual and/or Developmental Disabilities Community Based Residential Treatment Facility: A home-like residential facility providing habilitation, support and monitoring services to individuals diagnosed with intellectual and/or developmental disabilities.
Other intellectual and/or developmental disabilities community based residential treatment facility providers in Johnson City
About NPI 1417197153
Frontier Health's National Provider Identifier is 1417197153, issued on Feb 20, 2009. The primary taxonomy on file is Intellectual and/or Developmental Disabilities Community Based Residential Treatment Facility (320900000X), and the practice location is in Johnson City, TN. The record was last updated on Feb 20, 2009.