FRONTIER HEALTH NPI 1730245010

NPI Information

NPI: 1730245010
Provider Name: FRONTIER HEALTH

Doing Business As: VICTORY CENTER

Classification: Clinic/Center - 261QM0850X
Entity Type: Organization

Specialization: Adult Mental Health

Address:
2243 EDDIE WILLIAMS RD
JOHNSON CITY, TN
ZIP 37601
Phone: (423) 928-5627
Get Directions

FRONTIER HEALTH is an adult mental health clinic center in Johnson City, TN. The provider is an entity, facility, or distinct part of a facility providing diagnostic, treatment, and prescriptive services related to mental and behavioral disorders in adults. FRONTIER HEALTH NPI is 1730245010. The provider is registered as an organization entity type.
The provider Is Doing Business As Victory Center.

The provider's business location address is:

2243 EDDIE WILLIAMS RD
JOHNSON CITY, TN
ZIP 37601-872
Phone: (423) 928-5627
Fax: (423) 928-4222

The provider's authorized official is Teresa M Kidd .
The authorized official title is President And Ceo and has the following contact phone number (423) 467-3600.

The enumeration date for this NPI number is 12/29/2006 and was last updated on 12/12/2018.

Taxonomy Codes

The NPI record includes the healthcare provider taxonomy classification, state license number and state of licensure. The following information regarding the scope of practice of this provider is available:

No.	Taxonomy Code	Taxonomy Clasification	Taxonomy Specialization	License Number	License State	Primary
1	261QR0400X	Clinic/Center	Rehabilitation	L 229-076-1429	TENNESSEE	No
2	261QM0850X	Clinic/Center	Adult Mental Health	L 229-076-1429	TENNESSEE	Yes

Other Identifiers

The following information regarding additional identifiers associated to this NPI record includes the other identifier number, identifier type, identifier state and issuer.

No.	Other Provider Identifier	Other Provider Identifier Type	Other Provider Identifier State	Other Provider Identifier Issuer
1	49-4920-0	MEDICAID	VIRGINIA

What is NPI?

NPI stands for National Provider Identifier. The NPI is a 10-digit identification number that is completely unique. The NPI number by itself does not contain any identifiable information such as a provider’s speciality or location. The NPI is assigned to individuals or organizacions for their lifespan and it is independent of key provider information type updates like a change of practices, location or speciality.

This page was last updated on: 5/5/2024

NPI Synchronization or Removal

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