Organization
MOUNTAIN STATES HEALTH ALLIANCE
Active
Other names
Sycamore Shoals Hospital Psychiatric Unit
Organization subpart
No
Provider details
NPI number
Authorized official
SHANE EDWIN HILTON (EVP/CFO)
(423) 302-3467
Entity
Organization
Contact information
Practice address
1501 W ELK AVE, ELIZABETHTON, TN 37643-2874
(423) 542-1300
(423) 543-5372
Mailing address
311 PRINCETON RD STE 1, JOHNSON CITY, TN 37601-2026
(423) 542-1300
(423) 543-5372
Taxonomy
Speciality
Code
Description
License number
State
273R00000X
Psychiatric Hospital Unit
Primary
0000000012
TN
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
29725700
MAGELLAN
—
Enumeration date
08/31/2006
Last updated
04/16/2024
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