Organization
FRONTIER HEALTH
Active
Parent organization
FRONTIER HEALTH
Other names
CHURCH STREET PAVILION/VICTORY CENTER
Organization subpart
Yes
Provider details
NPI number
Legal business name
FRONTIER HEALTH
Authorized official
MR. E. DOUGLAS VARNEY (PRESIDENT & CEO)
(423) 467-3600
Entity
Organization
Contact information
Practice address
616 E CHURCH ST, GREENEVILLE, TN 37745-5084
(423) 639-3213
(423) 467-3644
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
I000000006376
TN
261QR0400X
Rehabilitation Clinic/Center
Primary
I000000006376
TN
Other
Enumeration date
05/14/2010
Last updated
05/14/2010
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