# FRONTIER HEALTH

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- **Entity:** Organization
- **Status:** Active
- **Other names:** Holston Children & Youth Services
- **Organization subpart:** No

## Provider details

- **NPI number:** 1578627006
- **Authorized official:** DR. TERESA M KIDD PHD (PRESIDENT AND CEO)
- **Authorized official phone:** (423) 467-3600

## Contact information

- **Practice address:** 2001 STONEBROOK PL, KINGSPORT, TN 37660-4000
- **Practice address phone:** (423) 224-1000
- **Practice address fax:** (423) 224-1023
- **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 |
| --- | --- | --- | --- | --- |
| 251B00000X | Case Management Agency | L 214-076-1417 | TN | — |
| 251S00000X | Community/Behavioral Health Agency | L 214-076-1417 | TN | — |
| 261QM0855X | Adolescent and Children Mental Health Clinic/Center | L 214-076-1417 | TN | Yes |
| 261QR0405X | Substance Use Disorder Rehabilitation Clinic/Center | 316 | TN | — |

## Other

- **Enumeration date:** 12/20/2006
- **Last updated:** 12/12/2018