Organization
MOUNTAIN STATES HEALTH ALLIANCE
Active
Organization
MOUNTAIN STATES HEALTH ALLIANCE
Active
Other names
Russell County Psychiatric Unit
Organization subpart
No
Provider details
NPI number
Authorized official
MARY LYNN KRUTAK (EVP/CFO)
(423) 302-3423
Entity
Organization
Contact information
Practice address
58 CARROLL ST, LEBANON, VA 24266-4510
(276) 883-8000
(276) 883-8250
Mailing address
311 PRINCETON RD STE 1, JOHNSON CITY, TN 37601-2026
(276) 883-8000
(276) 883-8250
Taxonomy
Speciality
Code
Description
License number
State
273R00000X
Psychiatric Hospital Unit
Primary
H1892
VA
Other
Enumeration date
01/31/2008
Last updated
03/29/2018
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