NPI 1669902243

Mountain States Health Alliance

Organisation Community Based Hospice Care Agency Clintwood, VA

Practice location

Address: 312 Hospital Dr Suite 1b, Clintwood, VA 24228
Phone: (276) 926-6600
Fax: (276) 926-6783
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 (2)

Community Based Hospice Care Agency Primary

Agencies Taxonomy 251G00000X

Other Hospice Care, Community Based providers in Virginia →

Community Based Hospice Care Agency

Agencies Taxonomy 251G00000X

Registry record

NPI: 1669902243
Entity type: Organization
NPI issued: 15 Jun 2017
Record last updated: 19 Feb 2019

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.