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Organization

MOUNTAIN STATES HEALTH ALLIANCE

Active
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Organization

MOUNTAIN STATES HEALTH ALLIANCE

Active
Other names
DBA Mountain States Outpatient Behavioral Health
Organization subpart
No

Provider details

NPI number
Authorized official
JEFFREY N DICE (ASSISTANT VICE PRESIDENT)
(423) 431-7060
Entity
Organization

Contact information

Practice address
508 PRINCETON COMMONS, SUITE 403, JOHNSON CITY, TN 37601-2060
(423) 722-3000
(423) 722-3009
Mailing address
508 PRINCETON COMMONS, SUITE 403, JOHNSON CITY, TN 37601-2060
(423) 722-3000
(423) 722-3009

Taxonomy

Speciality
Code
Description
License number
State
2084P0800X
Psychiatry Physician
Primary

Other

Enumeration date
10/18/2007
Last updated
11/02/2007
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