# MOUNTAIN STATES HEALTH ALLIANCE

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- **Entity:** Organization
- **Status:** Active
- **Other names:** Ballad Health Homecare
- **Organization subpart:** No

## Provider details

- **NPI number:** 1528166568
- **Authorized official:** SHANE EDWIN HILTON (EVP/CFO)
- **Authorized official phone:** (423) 302-3467

## Contact information

- **Practice address:** 96 15TH ST NW \# 104A, NORTON, VA 24273-1625
- **Practice address phone:** (276) 973-9481
- **Practice address fax:** (279) 973-9484
- **Mailing address:** 311 PRINCETON RD STE 1, JOHNSON CITY, TN 37601-2026
- **Mailing address phone:** (276) 973-9481
- **Mailing address fax:** (276) 973-9484

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 251E00000X | Home Health Agency | — | NULL | Yes |

## Other

- **Enumeration date:** 09/21/2006
- **Last updated:** 04/16/2024

## Other identifiers

| Code | Description | Identifier | Issuer | State |
| --- | --- | --- | --- | --- |
| 05 | — | 004970683 | — | VA |