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Organization
MOUNTAIN STATES HEALTH ALLIANCE
Active
Organization
MOUNTAIN STATES HEALTH ALLIANCE
Active
Other names
Ballad Health Homecare
Organization subpart
No
Provider details
NPI number
Authorized official
SHANE EDWIN HILTON (EVP/CFO)
(423) 302-3467
Entity
Organization
Contact information
Practice address
96 15TH ST NW # 104A, NORTON, VA 24273-1625
(276) 973-9481
(279) 973-9484
Mailing address
311 PRINCETON RD STE 1, JOHNSON CITY, TN 37601-2026
(276) 973-9481
(276) 973-9484
Taxonomy
Speciality
Code
Description
License number
State
251E00000X
Home Health Agency
Primary
—
NULL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
004970683
—
VA
Enumeration date
09/21/2006
Last updated
04/16/2024
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