NPI 1033225206

Mountain States Health Alliance

Organisation Community Based Hospice Care Agency Johnson City, TN

Practice location

Address: 509 Med Tech Pkwy STE 300, Johnson City, TN 37604-2579
Phone: (423) 431-6146
Fax: (423) 431-7655
Mailing address: 311 Princeton Rd STE 1, Johnson City, TN 37601-2026

Authorised official

Name: Mary Lynn Krutak
Title: Evp/Cfo
Phone: (423) 302-3423

Registered specialties

Community Based Hospice Care Agency Primary

Agencies Taxonomy 251G00000X Licence 0000000390 (TN)

Other Hospice Care, Community Based providers in Tennessee →

Registry record

NPI: 1033225206
Entity type: Organization
NPI issued: 21 Aug 2006
Record last updated: 19 Dec 2018

Reproduced from NPPES, the federal provider registry. The date above is when the provider last updated their own entry, not when we fetched it - a record can be years old and still current in the registry.