# MOUNTAIN STATES HEALTH ALLIANCE

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- **Entity:** Organization
- **Status:** Active
- **Other names:** Princeton Transitional Care
- **Organization subpart:** No

## Provider details

- **NPI number:** 1841393329
- **Authorized official:** MARY LYNN KRUTAK (EVP/CFO)
- **Authorized official phone:** (423) 302-3423

## Contact information

- **Practice address:** 400 N STATE OF FRANKLIN RD, JOHNSON CITY, TN 37604-6035
- **Practice address phone:** (423) 431-6111
- **Practice address fax:** (423) 431-6525
- **Mailing address:** 311 PRINCETON RD STE 1, JOHNSON CITY, TN 37601-2026
- **Mailing address phone:** (423) 431-6111
- **Mailing address fax:** (423) 431-6525

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 314000000X | Skilled Nursing Facility | 0000000337 | TN | Yes |

## Other

- **Enumeration date:** 09/07/2006
- **Last updated:** 02/21/2018