Organization
FRONTIER HEALTH
Active
Other names
Tennessee Community Support Services
Organization subpart
No
Provider details
NPI number
Authorized official
ROBIN DENISE DENTON BSOM (UM COORDINATOR)
(423) 467-3600
Entity
Organization
Contact information
Practice address
266 NORTH ST, BRISTOL, TN 37620-1660
(423) 989-4558
(423) 989-4570
Mailing address
PO BOX 9054, GRAY, TN 37615-9054
(423) 467-3600
(423) 467-3644
Taxonomy
Speciality
Code
Description
License number
State
251B00000X
Case Management Agency
L 214-076-1428
TN
251S00000X
Community/Behavioral Health Agency
L 214-076-1428
TN
261QM0850X
Adult Mental Health Clinic/Center
Primary
L 214-076-1428
TN
261QR0405X
Substance Use Disorder Rehabilitation Clinic/Center
L 214-076-1428
TN
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
3920247
—
TN
Enumeration date
12/29/2006
Last updated
08/01/2019
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