| Organization Name: | MOUNTAIN STATES HEALTH ALLIANCE |
| NPI Number: | 1881797371 |
| Entity Type Code: | Organizational (2) |
| Authorized Official Name: | MARY LYNN KRUTAK (SVP/CFO) |
| Mailing Address: | 403 N State Of Franklin Rd Johnson City |
| State: | TN US |
| Postal Code: | 376046034 |
| Phone Number: | 4239287111 |
| Fax Number: | 4234317092 |
| NPI Enumeration Date: | 09/07/2006 |
| NPI Last Update Date: | 11/03/2015 |
| Replacement NPI: | 0 |
| NPI Deactivation Date: | |
| NPI Reactivation Date: |
Taxonomy Information: | |
| Healthcare Provider Taxonomy: | 273R00000X |
| License Number: | 000000121 |
| Healthcare Provider Taxonomy: (Secondary) | Y |
| State: | TN |
| Taxonomy Type: | Hospital Units |
| Taxonomy Classification: | Psychiatric Unit |
| Taxonomy Specialization: | |
| Taxonomy Definition: | In general, a distinct unit of a hospital that provides acute or long-term care to emotionally disturbed patients, including patients admitted for diagnosis and those admitted for treatment of psychiatric problems on the basis of physicians |