Organization
MOUNTAIN STATES HEALTH ALLIANCE
Active
Other names
Princeton Transitional Care
Organization subpart
No
Provider details
NPI number
Authorized official
MARY LYNN KRUTAK (EVP/CFO)
(423) 302-3423
Entity
Organization
Contact information
Practice address
400 N STATE OF FRANKLIN RD, JOHNSON CITY, TN 37604-6035
(423) 431-6111
(423) 431-6525
Mailing address
311 PRINCETON RD STE 1, JOHNSON CITY, TN 37601-2026
(423) 431-6111
(423) 431-6525
Taxonomy
Speciality
Code
Description
License number
State
314000000X
Skilled Nursing Facility
Primary
0000000337
TN
Other
Enumeration date
09/07/2006
Last updated
02/21/2018
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