OrganizationActive
Frontier Health
NPI 1265632392 · Mental Illness Community Based Residential Treatment Facility · Johnson City, TN
Provider details
- NPI number
- 1265632392
- Entity type
- Organization
- Primary specialty
- Mental Illness Community Based Residential Treatment FacilityResidential Treatment Facilities
- Parent organization
- Frontier Health
- Organization subpart
- Yes
- Authorized official
- E Varney, President and Ceo(423) 467-3600
- License
- L 219-076-1421 (TN)
Specialties & taxonomies
- Mental Illness Community Based Residential Treatment FacilityPrimary320800000XLicense L 219-076-1421 (TN)
Residential Treatment Facilities
Practice location
516 Swadley Rd
Johnson City, TN 37601-9000
Phone: (423) 926-9001
Fax: (423) 232-2752
Approximate (ZIP-level) locationGet directions
Mailing address
Po Box 9054
Gray, TN 37615-9054
Other names (DBA / former)
- Doing business as
- Laurel House
Registry dates
- Enumerated
- 2007-07-18
- Last updated
- 2007-07-18
Source: CMS NPPES Data Dissemination (June 2026). NPI Central is not affiliated with CMS. Data is provided as-is from the public registry.