Organization
FRONTIER HEALTH
Active
Organization
FRONTIER HEALTH
Active
Other names
FAIRMOUNT GROUP HOME, Faimount Group Home
Organization subpart
No
Provider details
NPI number
Authorized official
MRS. KRISTIE HAMMONDS (PRESIDENT AND CEO)
(423) 467-3600
Entity
Organization
Contact information
Practice address
719 KENTUCKY AVE, BRISTOL, TN 37620-3806
(423) 968-2532
Mailing address
PO BOX 9054, GRAY, TN 37615-9054
(423) 467-3600
(423) 467-3644
Taxonomy
Speciality
Code
Description
License number
State
320900000X
Intellectual and/or Developmental Disabilities Community Based Residential Treatment Facility
Primary
L 324-076-1411
TN
Other
Enumeration date
05/03/2007
Last updated
01/10/2020
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