# FRONTIER HEALTH

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- **Entity:** Organization
- **Status:** Active
- **Other names:** Park Place Residential Service
- **Organization subpart:** No

## Provider details

- **NPI number:** 1790836831
- **Authorized official:** MR. E DOUGLAS VARNEY (PRESIDENT AND CEO)
- **Authorized official phone:** (423) 467-3600

## Contact information

- **Practice address:** 103 FRALEY AVE, DUFFIELD, VA 24244-9798
- **Practice address phone:** (276) 443-1415
- **Practice address fax:** (276) 431-2640
- **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 |
| --- | --- | --- | --- | --- |
| 320900000X | Intellectual and/or Developmental Disabilities Community Based Residential Treatment Facility | 315-01-001 | VA | — |
| 385HR2060X | Child Intellectual and/or Developmental Disabilities Respite Care | 315-01-001 | VA | Yes |

## Other

- **Enumeration date:** 01/16/2007
- **Last updated:** 09/11/2025