Organization · Type 2 NPI

Frontier Health

Intellectual and/or Developmental Disabilities Community Based Residential Treatment Facility · Bristol, TN

NPI number 1922164599 Active

Practice location

1135 Volunteer Pkwy Ste 14
Bristol, TN 37620-4658

Call (423) 878-1600 Map

Fax (423) 878-1606

Mailing address

PO Box 9054
Gray, TN 37615-9054

Specialties and licenses

Taxonomy	Code	License
Developmentally Disabled Services Day Training Agency	251C00000X	L (20)24M6-076-1413 (TN)
Intellectual and/or Developmental Disabilities Community Based Residential Treatment Facility Primary	320900000X	L (20)24M6-076-1413 (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 Bristol

See all in Bristol →

NPI record

NPI: 1922164599
Entity type: Organization (Type 2)
Issued: Dec 28, 2006
Last updated: Jul 14, 2021
Status: Active

Other names

<unavail>
Frontier Industries Bristol · doing business as
Frontier Industries Bristol · doing business as

Authorized official

Mrs. Kristie Hammonds
President and CEO
(423) 467-3600

Verify this record

This page mirrors the public NPPES file. For credentialing or billing, confirm it on the official CMS NPI Registry, and check the license with the state board.

Is this your record? How to update it.

About NPI 1922164599

Frontier Health's National Provider Identifier is 1922164599, issued on Dec 28, 2006. The primary taxonomy on file is Intellectual and/or Developmental Disabilities Community Based Residential Treatment Facility (320900000X), and the practice location is in Bristol, TN. The record was last updated on Jul 14, 2021.