OrganizationActive
Mountain States Health Alliance
NPI 1417050980 · Psychiatric Hospital Unit · Kingsport, TN
Provider details
- NPI number
- 1417050980
- Entity type
- Organization
- Primary specialty
- Psychiatric Hospital UnitHospital Units
- Organization subpart
- No
- Authorized official
- Mary Krutak, Svp/Cfo(423) 431-6111
- License
- 0000000134 (TN)
Specialties & taxonomies
Hospital Units
Practice location
2300 Pavilion Dr
Kingsport, TN 37660-4622
Phone: (423) 857-5500
Fax: (423) 857-7078
Approximate (ZIP-level) locationGet directions
Mailing address
311 Princeton Rd
Johnson City, TN 37601-2026
Other names (DBA / former)
- Doing business as
- Indian Path Pavilion
Registry dates
- Enumerated
- 2006-09-07
- Last updated
- 2015-10-15
Source: CMS NPPES Data Dissemination (June 2026). NPI Central is not affiliated with CMS. Data is provided as-is from the public registry.