Organization
MOUNTAIN STATES HEALTH ALLIANCE
Active
Other names
Ballad Health Hospice
Organization subpart
No
Provider details
NPI number
Authorized official
MARY LYNN KRUTAK (EVP/CFO)
(423) 302-3423
Entity
Organization
Contact information
Practice address
509 MED TECH PKWY STE 300, JOHNSON CITY, TN 37604-2579
(423) 431-6146
(423) 431-7655
Mailing address
311 PRINCETON RD STE 1, JOHNSON CITY, TN 37601-2026
(423) 431-6146
(423) 431-7655
Taxonomy
Speciality
Code
Description
License number
State
251G00000X
Community Based Hospice Care Agency
Primary
0000000390
TN
Other
Enumeration date
08/21/2006
Last updated
12/19/2018
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