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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