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Organization
MOUNTAIN STATES HEALTH ALLIANCE
Active
Organization
MOUNTAIN STATES HEALTH ALLIANCE
Active
Other names
Mountain States Rehabilitation at RCMC
Organization subpart
No
Provider details
NPI number
Authorized official
MARY LYNN KRUTAK (EVP/CFO)
(423) 302-3423
Entity
Organization
Contact information
Practice address
111 S FLANNAGAN AVENUE, LEBANON, VA 24266-4515
(276) 883-8095
(276) 883-8097
Mailing address
311 PRINCETON RD STE 1, JOHNSON CITY, TN 37601-2026
(276) 883-8095
(276) 883-8097
Taxonomy
Speciality
Code
Description
License number
State
282N00000X
General Acute Care Hospital
Primary
H 1892
VA
Other
Enumeration date
06/02/2015
Last updated
03/29/2018
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