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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