Provider Type Icon

MOUNTAIN STATES HEALTH ALLIANCE NPI 1023434339


NPI Information

NPI: 1023434339
Provider Name: MOUNTAIN STATES HEALTH ALLIANCE

Doing Business As: WOODRIDGE HOSPITAL

Classification: Psychiatric Unit - 273R00000X
Entity Type: Organization

CLIA Number: 44D0969252

Address:
403 N STATE OF FRANKLIN RD
JOHNSON CITY, TN
ZIP 37604
Phone: (423) 431-7111
Get Directions

MOUNTAIN STATES HEALTH ALLIANCE is a psychiatric unit in Johnson City, TN. The provider is 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' orders and approved nursing care plans. Long-term care may include intensive supervision to the chronically mentally ill, mentally disordered or other mentally incompetent persons; (2) For Medicare, a distinct part of a general acute care hospital admitting only patients whose admission to the unit is required for active treatment, whose treatment is of an intensity that can be provided only in an inpatient hospital setting, and whose condition is described by a psychiatric principal diagnosis contained in the Third Edition of the American Psychiatric Association Diagnostic and Statistical Manual or in Chapter 5 (Mental Disorders) of the International Classification of Diseases, Ninth Revision, Clinical Modification (ICD-9-CM). The unit must furnish, through the use of qualified personnel, psychological services, social work services, psychiatric nursing, occupational therapy, and recreational therapy. The unit must maintain medical records that permit determination of the degree and intensity of treatment provided to individuals who are furnished services in the unit; the unit must meet special staff requirements in that the unit must have adequate numbers of qualified professional and supportive staff to evaluate inpatients, formulate written, individualized, comprehensive treatment plans, provide active treatment measures and engage in discharge planning. MOUNTAIN STATES HEALTH ALLIANCE NPI is 1023434339. The provider is registered as an organization entity type.
The provider Is Doing Business As Woodridge Hospital.

The provider's business location address is:

403 N STATE OF FRANKLIN RD
JOHNSON CITY, TN
ZIP 37604-034
Phone: (423) 431-7111
Fax: (423) 431-7301

The provider's authorized official is Mary Lynn Krutak .
The authorized official title is Evp/cfo and has the following contact phone number (423) 302-3423.

The CLIA number assigned to this NPI record is 44D0969252 - home health agency with a certificate type of Certificate of Waiver.

The enumeration date for this NPI number is 3/11/2014 and was last updated on 10/20/2021.


Taxonomy Codes

The NPI record includes the healthcare provider taxonomy classification, state license number and state of licensure. The following information regarding the scope of practice of this provider is available:

No.Taxonomy CodeTaxonomy ClasificationTaxonomy SpecializationLicense NumberLicense StatePrimary
1273R00000XPsychiatric Unit0000000121TENNESSEEYes

What is NPI?

NPI stands for National Provider Identifier. The NPI is a 10-digit identification number that is completely unique. The NPI number by itself does not contain any identifiable information such as a provider’s speciality or location. The NPI is assigned to individuals or organizacions for their lifespan and it is independent of key provider information type updates like a change of practices, location or speciality.

This page was last updated on: 11/14/2023

All materials and services on this site are provided on an "as is" and "as available" basis without warranty of any kind. The NPI record is maintained by the National Plan & Provider Enumeration System (NPPES) and anyone may request this information and other NPPES health care provider data from HHS under The Freedom of Information Act (FOIA), Title 5 of the United States Code, section 552. To update the NPI records please contact the NPPES.