# MOUNTAIN STATES HEALTH ALLIANCE

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- **Entity:** Organization
- **Status:** Active
- **Other names:** Johnson County Home Health
- **Organization subpart:** No

## Provider details

- **NPI number:** 1306957659
- **Authorized official:** GREGORY LEE WILGOCKI (CORP DIRECTOR REIMBURSEMENT)
- **Authorized official phone:** (423) 431-5794

## Contact information

- **Practice address:** 1987A S SHADY ST, MOUNTAIN CITY, TN 37683-2021
- **Practice address phone:** (423) 727-3250
- **Practice address fax:** (423) 727-9170
- **Mailing address:** 311 PRINCETON RD STE 1, JOHNSON CITY, TN 37601-2026
- **Mailing address phone:** (423) 727-3250
- **Mailing address fax:** (423) 727-9170

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 251E00000X | Home Health Agency | 0000000130 | TN | Yes |

## Other

- **Enumeration date:** 08/31/2006
- **Last updated:** 07/21/2022