Organization
FRONTIER HEALTH
Active
Other names
Addington Hall
Organization subpart
No
Provider details
NPI number
Authorized official
DR. TERESA M KIDD PHD (PRESIDENT AND CEO)
(423) 467-3600
Entity
Organization
Contact information
Practice address
1100 US HIGHWAY 58, DUFFIELD, VA 24244
(276) 431-4370
(276) 431-2863
Mailing address
PO BOX 9054, GRAY, TN 37615-9054
Taxonomy
Speciality
Code
Description
License number
State
251B00000X
Case Management Agency
315-16-001
VA
261QM0855X
Adolescent and Children Mental Health Clinic/Center
315-07-004
VA
385HR2055X
Child Mental Illness Respite Care
315-03-001
VA
385HR2060X
Child Intellectual and/or Developmental Disabilities Respite Care
Primary
315-03-001
VA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
49-4129-2
—
VA
Enumeration date
12/13/2006
Last updated
10/04/2018
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