Organization
FRONTIER HEALTH
Active
Other names
Erwin Mental Health Center
Organization subpart
No
Provider details
NPI number
Authorized official
MRS. KRISTIE HAMMONDS (PRESIDENT)
(423) 467-3600
Entity
Organization
Contact information
Practice address
218 N MAIN AVE, ERWIN, TN 37650-1234
(423) 743-1470
(423) 467-3644
Mailing address
1167 SPRATLIN PARK DRIVE, GRAY, TN 37615-9054
(423) 467-3600
(423) 467-3644
Taxonomy
Speciality
Code
Description
License number
State
251B00000X
Case Management Agency
L-214-076-1410
TN
251B00000X
Case Management Agency
Primary
L000000015381
TN
251S00000X
Community/Behavioral Health Agency
L-214-076-1410
TN
251S00000X
Community/Behavioral Health Agency
L000000015381
TN
261QM0801X
Mental Health Clinic/Center (Including Community Mental Health Center)
L-214-076-1410
TN
261QM0801X
Mental Health Clinic/Center (Including Community Mental Health Center)
L000000015381
TN
261QR0405X
Substance Use Disorder Rehabilitation Clinic/Center
322
TN
261QR0405X
Substance Use Disorder Rehabilitation Clinic/Center
L000000015381
TN
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
3920247
—
TN
05
—
49-4913-7
—
VA
05
—
SAME AS MEDICARE #S
—
TN
Enumeration date
12/14/2006
Last updated
01/10/2020
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