# FRONTIER HEALTH

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- **Entity:** Organization
- **Status:** Active
- **Other names:** Adventure Program
- **Organization subpart:** No

## Provider details

- **NPI number:** 1235298720
- **Authorized official:** CRISTI L BLALOCK MBA (DIRECTOR CONTRACTING/ COMPLIANCE)
- **Authorized official phone:** (423) 467-3741

## Contact information

- **Practice address:** 210 E WATAUGA AVE, JOHNSON CITY, TN 37601-4630
- **Practice address phone:** (423) 232-4326
- **Practice address fax:** (423) 232-4255
- **Mailing address:** PO BOX 9054, GRAY, TN 37615-9054
- **Mailing address phone:** (423) 467-3600
- **Mailing address fax:** (423) 467-3644

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 261QM0855X | Adolescent and Children Mental Health Clinic/Center | 315 | TN | Yes |

## Other

- **Enumeration date:** 12/08/2006
- **Last updated:** 07/01/2025