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ROLLER RUSS RESIDENCE FOR INDEPENDENT LIVING
NPI 1265597280
Community Based Residential Treatment Facility, Mental Illness in Kingsport, TN

Active since December 27, 2006
2221 MEMORIAL CT, KINGSPORT, TN 37664(423) 245-1121(423) 467-3644 Get Directions Write a Review

NPPES record last updated: August 22, 2020. Verified against the NPPES registry weekly; last sync: July 19, 2026.

About Roller Russ Residence For Independent Living NPPES

Official registry information on file with the National Plan and Provider Enumeration System.

ROLLER RUSS RESIDENCE FOR INDEPENDENT LIVING (NPI 1265597280) is a healthcare organization registered as a community based residential treatment facility, mental illness in Kingsport, Tennessee and active in the NPI registry since December 2006. The organization lists E Douglas Varney, President And Ceo, as its authorized official.

NPPES Registry Identity

NPI1265597280
Entity TypeOrganization
Primary Taxonomy320800000X
Legal Business NameFRONTIER HEALTH
Location Address2221 MEMORIAL CTKingsport, TN 37664-3339
Mailing AddressPo Box 9054Gray, TN 37615-9054 · (423) 467-3600 · Fax (423) 467-3644
Phone(423) 245-1121
Fax(423) 467-3644
Organization SubpartNo
Authorized OfficialE Douglas VarneyPresident And Ceo · (423) 467-3600
Enumeration DateDecember 27, 2006
Last NPPES UpdateAugust 22, 2020
✔ NPI 1265597280 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyCommunity Based Residential Treatment Facility, Mental IllnessResidential Treatment Facilities
Taxonomy Code320800000X
License✔ Licensed in TN · L 219-076-1426
Definition

A home-like residential facility providing psychiatric treatment and psycho/social rehabilitative services to individuals diagnosed with mental illness.

2221 MEMORIAL CT, Kingsport, TN 37664
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Other Names 1

Doing Business AsRoller Russ Residence For Independent Living

Frequently Asked Questions

What is FRONTIER HEALTH's NPI number?

The NPI number assigned to this healthcare provider is 1265597280, enumerated as an "organization" on December 27, 2006.

Where is the provider located?

The provider is located at 2221 MEMORIAL CT KINGSPORT, TN 37664 and the phone number is (423) 245-1121.

What is the provider's specialty?

Community Based Residential Treatment Facility, Mental Illness with taxonomy code 320800000X.