Mountain States Health Alliance
Hospice Care, Community Based in Clintwood, VA. Organization (NPI-2).
NPI number1669902243
StatusActive
Last updated in NPPESFeb 19, 2019
Details
- NPI
- 1669902243
- Entity type
- Organization (NPI-2)
- Legal business name
- Mountain States Health Alliance
- Organization subpart
- No
- Enumeration date
- Jun 15, 2017
- Last updated
- Feb 19, 2019
Taxonomy and licenses
| Taxonomy code | Description | License | State | Primary |
|---|---|---|---|---|
| 251G00000X | Hospice Care, Community Based | – | – | Yes |
| 251G00000X | Hospice Care, Community Based | – | VA |
Other names
- Ballad Health Hospice (Doing Business As)
Practice location
312 Hospital Dr Suite 1bClintwood, VA 24228
Phone 276-926-6600 · Fax 276-926-6783
Mailing address
311 Princeton Rd Ste 1Johnson City, TN 37601-2026
Phone 276-926-6600 · Fax 276-926-6783
Authorized official
Mary Lynn Krutak
Evp/Cfo
4233023423
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