Organization
FRONTIER HEALTH
Active
Other names
Polly Summit
Organization subpart
No
Provider details
NPI number
Authorized official
MR. E DOUGLAS VARNEY (PRESIDENT AND CEO)
(423) 467-3600
Entity
Organization
Contact information
Practice address
100 LAUREL RIDGE DR, BIG STONE GAP, VA 24219-2756
(276) 523-0028
(276) 523-0029
Mailing address
PO BOX 9054, GRAY, TN 37615-9054
(423) 467-3600
(423) 467-3644
Taxonomy
Speciality
Code
Description
License number
State
320800000X
Mental Illness Community Based Residential Treatment Facility
Primary
315-01-002
VA
320900000X
Intellectual and/or Developmental Disabilities Community Based Residential Treatment Facility
315-01-002
VA
Other
Enumeration date
01/16/2007
Last updated
09/11/2025
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