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Organization
MOUNTAIN STATES HEALTH ALLIANCE
Active
Organization
MOUNTAIN STATES HEALTH ALLIANCE
Active
Other names
James H. & Cecile C. Quillen Rehabilitation Hospital
Organization subpart
No
Provider details
NPI number
Authorized official
MARY LYNN KRUTAK (SVP/CFO)
(423) 302-3374
Entity
Organization
Contact information
Practice address
2511 WESLEY ST, JOHNSON CITY, TN 37601-1723
(423) 952-1700
(423) 431-6525
Mailing address
311 PRINCETON RD, JOHNSON CITY, TN 37601-2026
Taxonomy
Speciality
Code
Description
License number
State
273Y00000X
Rehabilitation Hospital Unit
Primary
0000000121
TN
Other
Enumeration date
08/28/2006
Last updated
10/30/2015
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