Organization
FRONTIER HEALTH
Active
Other names
GIBSON PLACE 210
Organization subpart
No
Provider details
NPI number
Authorized official
MRS. KRISTIE HAMMONDS (PRESIDENT & CEO)
(423) 467-3600
Entity
Organization
Contact information
Practice address
210 QUARY RD, JOHNSON CITY, TN 37601-7580
(423) 232-7234
(423) 467-3644
Mailing address
1167 SPRATLIN PARK DR, GRAY, TN 37615-6205
(423) 467-3600
(423) 467-3644
Taxonomy
Speciality
Code
Description
License number
State
323P00000X
Psychiatric Residential Treatment Facility
Primary
I000000012508
TN
Other
Enumeration date
05/08/2013
Last updated
01/10/2020
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