MOUNTAIN STATES HEALTH ALLIANCE (NPI# 1669902243) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1669902243 |
| Entity Type | Organization |
| Organization Name | MOUNTAIN STATES HEALTH ALLIANCE |
| Other Organization Name | BALLAD HEALTH HOSPICE |
| Practice Address |
312 Hospital Dr Suite 1b Clintwood VA 24228 |
| Mailing Address |
311 Princeton Rd Ste 1 Johnson City TN 37601-2026 |
| Practice Telephone | 2769266600 |
| Practice Fax Number | 2769266783 |
| Mailing Telephone | 2769266600 |
| Mailing Fax Number | 2769266783 |
| Enumeration Date | 2017-06-15 |
| Last Update Date | 2019-02-19 |
| Authorized Official Name | MARY LYNN KRUTAK (EVP/CFO) |
| Authorized Official Telephone | 4233023423 |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| N | 251G00000X | Hospice Care, Community Based | VA | Agencies | |
| Y | 251G00000X | Hospice Care, Community Based | Agencies |
| Other Name | Type Code |
|---|---|
| Ballad Health Hospice | Doing Business As Name - Organization |
| Dickenson County Hospice | Doing Business As Name - Organization |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1962998732 | Mountain States Health Alliance | Home Health | 312 Cummings St Ste A, Abingdon, VA 24210-3200 | 2018-07-05 |
| 1336635192 | Mountain States Health Alliance | Hospice, Inpatient | 312 Cummings St Ste B, Abingdon, VA 24210-3200 | 2018-07-05 |
| 1316476211 | Mountain States Health Alliance | Home Health | 312 Hospital Dr Suite 1a, Clintwood, VA 24228 | 2017-06-06 |
| 1073064333 | Mountain States Health Alliance | General Acute Care Hospital | 400 N St of Franklin Rd, Johnson City, TN 37604 | 2016-10-20 |
| 1245781954 | Mountain States Health Alliance | Family Medicine | 58 Carroll St Suite 3, Dept of Russell County Medical Center, Lebanon, VA 24266 | 2016-10-18 |
| 1316322555 | Mountain States Health Alliance | General Acute Care Hospital | 81 S Flanagan Avenue, Lebanon, VA 24266-4515 | 2015-07-29 |
| 1619357928 | Mountain States Health Alliance | General Acute Care Hospital | 111 S Flannagan Avenue, Lebanon, VA 24266-4515 | 2015-06-02 |
| 1700054095 | Mountain States Health Alliance | Psychiatry & Neurology | 58 Carroll Steet, Lebanon, VA 24266 | 2008-02-20 |
| 1609054733 | Mountain States Health Alliance | Clinic/Center | 16431 Wise Street, Saint Paul, VA 24283-3537 | 2008-01-31 |
| 1144408279 | Mountain States Health Alliance | Hospice Care, Community Based | 75 S Flannagan Ave, Lebanon, VA 24266 | 2008-01-31 |
| Entity Type | Entity Name | Entity Address |
|---|---|---|
| North Carolina Corporations | Mountain States Health Alliance | 160 Mine Lake Ct Ste 200, Raleigh, NC 27615 |
| Virginia Business Entities | Mountain States Health Alliance | 400 N State of Franklin Rd, Johnson City, Tennessee 37604 |
| Street Address |
312 HOSPITAL DR SUITE 1B |
| City | CLINTWOOD |
| State | VA |
| Zip Code | 24228 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1851816953 | Walgreen Co | Durable Medical Equipment & Medical Supplies | 5451 Dickenson Hwy, Clintwood, VA 24228 | 2017-08-09 |
| 1316476211 | Mountain States Health Alliance | Home Health | 312 Hospital Dr Suite 1a, Clintwood, VA 24228 | 2017-06-06 |
| 1134667009 | Amy Meade | Pharmacist | 342 Main Street, Clintwood, VA 24228 | 2017-02-10 |
| 1881087385 | Family Preservation Services, Inc | Community/Behavioral Health | 1381 Rose Ridge Ct, Clintwood, VA 24228 | 2015-03-09 |
| 1477951515 | Tauna Gulley | Nurse Practitioner | 233 Chase Street, Suite 100, Clintwood, VA 24228 | 2014-12-05 |
| 1740696152 | Family Preservation Services, Inc. | Community/Behavioral Health | 5123 Dickenson Highway, Clintwood, VA 24228 | 2014-07-07 |
| 1962816884 | Family Preservation Services, Inc | Community/Behavioral Health | 5123 & 5127 Dickenson Highway, Clintwood, VA 24228 | 2014-06-18 |
| 1003163643 | Family Preservation Services, Inc | Community/Behavioral Health | 150 Elementary Circle, Clintwood, VA 24228 | 2012-08-14 |
| 1265739122 | Family Preservation Services, Inc. | Community/Behavioral Health | Technology Park Drive, Clintwood, VA 24228 | 2011-02-11 |
| 1972810117 | Lisa M Howard | Pharmacist | Corner of Route 83 and Brushcreek Road, Clintwood, VA 24228 | 2010-09-09 |
| Find all providers in zip 24228 | ||||
| Taxonomy Code | 251G00000X |
| Grouping | Agencies |
| Classification | Hospice Care, Community Based |
| Definition to come... |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1780765206 | Homemakers LLC | Hospice Care, Community Based | 458 Colley Shopping Center, Clintwood, VA 24228 | 2006-10-18 |
| 1962684936 | Homemakers | Hospice Care, Community Based | 458 Colley Shopping Center, Clintwood, VA 24228 | 2007-12-03 |
| 1831371707 | Homemakers | Hospice Care, Community Based | 458 Colley Shopping Center, Clintwood, VA 24228 | 2007-12-03 |
| 1073563896 | Dickenson County Home Health & Hospice, Inc | Hospice Care, Community Based | 230 Chase St, Clintwood, VA 24228-5991 | 2006-05-11 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1073112678 | A Step Above Health Services | Hospice Care, Community Based | 2450 Randolph Creek Rd, New Canton, VA 23123-2418 | 2020-10-23 |
| 1881293835 | Riverside Health Source LLC | Hospice Care, Community Based | 289 Hospital Rd, Tappahannock, VA 22560-5145 | 2020-10-21 |
| 1699373449 | Affinity Care of Virginia LLC | Hospice Care, Community Based | 714 Thimble Shoals Blvd Ste C, Newport News, VA 23606-2574 | 2020-10-14 |
| 1730786138 | Serenity First, LLC | Hospice Care, Community Based | 4915 Fitzhugh Ave, Richmond, VA 23230-3544 | 2020-10-08 |
| 1477169811 | Advance Care Hospice, LLC | Hospice Care, Community Based | 585 Southlake Blvd Ste A, North Chesterfield, VA 23236-3198 | 2020-09-21 |
| 1689285660 | Va State Transportation LLC | Hospice Care, Community Based | 11079 Quail Whistle Dr, Glen Allen, VA 23059-5200 | 2020-08-12 |
| 1386263499 | Trinity Hospice 1, LLC | Hospice Care, Community Based | 1401 Kempsville Road, Suite A, Unit 1, Chesapeake, VA 23320 | 2020-04-09 |
| 1114550134 | Athc - Hospice, LLC | Hospice Care, Community Based | 1121 Heatherstone Dr, Fredericksburg, VA 22407-4828 | 2020-02-18 |
| 1548893951 | 24/7 We Care, LLC | Hospice Care, Community Based | 900 Granby St, Norfolk, VA 23510-2503 | 2020-02-14 |
| 1548806573 | All-4-one Home Healthcare Services, Inc. | Hospice Care, Community Based | 1629 Salem Rd Ste 101, Virginia Beach, VA 23456-5494 | 2019-11-25 |
| Find all providers with the same taxonomy | ||||
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| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.