Organization
FREE WILL BAPTIST FAMILY MINISTRIES, INC.
Active
Other names
Bristol Boys Home
Organization subpart
No
Provider details
NPI number
Authorized official
DR. JAMES KILGORE PH.D (CHIEF EXECUTIVE OFFICER)
(423) 639-9449
Entity
Organization
Contact information
Practice address
15149 OLD JONESBORO ROAD, BRISTOL, VA 24202-4623
(276) 466-5051
(276) 466-5045
Mailing address
90 STANLEY LANE, GREENEVILLE, TN 37743
(423) 639-9449
(423) 639-5083
Taxonomy
Speciality
Code
Description
License number
State
320800000X
Mental Illness Community Based Residential Treatment Facility
Primary
SS-304-06
VA
Other
Enumeration date
09/25/2006
Last updated
08/22/2020
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