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Organization

FRONTIER HEALTH

Active
Other names
Victory Center
Organization subpart
No

Provider details

NPI number
Authorized official
DR. CRISTI L BLALOCK MBA (DIR. CONTRACTING/COMPLIANCE)
(423) 467-3741
Entity
Organization

Contact information

Practice address
2243 EDDIE WILLIAMS RD, JOHNSON CITY, TN 37601-2872
(423) 928-5627
(423) 928-4222
Mailing address
PO BOX 9054, GRAY, TN 37615-9054
(423) 467-3600
(423) 467-3644

Taxonomy

Speciality
Code
Description
License number
State
261QM0850X
Adult Mental Health Clinic/Center
L 229-076-1429
TN
261QR0400X
Rehabilitation Clinic/Center
Primary

Other

Enumeration date
12/29/2006
Last updated
08/11/2025
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