# FRONTIER HEALTH

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- **Entity:** Organization
- **Status:** Active
- **Other names:** GIBSON PLACE 208
- **Organization subpart:** No

## Provider details

- **NPI number:** 1841635562
- **Authorized official:** MRS. KRISTIE HAMMONDS (PRESIDENT & CEO)
- **Authorized official phone:** (423) 467-3600

## Contact information

- **Practice address:** 208 QUARY RD, JOHNSON CITY, TN 37601-7580
- **Practice address phone:** (423) 232-7234
- **Practice address fax:** (423) 467-3644
- **Mailing address:** 1167 SPRATLIN PARK DR, GRAY, TN 37615-6205
- **Mailing address phone:** (423) 467-3600
- **Mailing address fax:** (423) 467-3644

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 323P00000X | Psychiatric Residential Treatment Facility | I000000012507 | TN | Yes |

## Other

- **Enumeration date:** 05/08/2013
- **Last updated:** 01/10/2020