| Mountain States Health Alliance Out-patient Behavioral Health | |
|
2012 Brookside Dr Kingsport TN 37660-4645 | |
| (423) 857-5566 | |
| (423) 857-5564 |
| Full Name | Mountain States Health Alliance Out-patient Behavioral Health |
|---|---|
| Speciality | Psychologist - Health Service |
| Location | 2012 Brookside Dr, Kingsport, Tennessee |
| Authorized Official Name and Position | Graciela Pereira (AVP BEHAVIORAL HEALTH AND REHAB SER) |
| Authorized Official Contact | 4239521701 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Mountain States Health Alliance Out-patient Behavioral Health 1021 W Oakland Ave Suite 207 Johnson City TN 37604-2191 Ph: (423) 952-3104 | Mountain States Health Alliance Out-patient Behavioral Health 2012 Brookside Dr Kingsport TN 37660-4645 Ph: (423) 857-5566 |
| NPI Number | 1083936033 |
|---|---|
| Provider Enumeration Date | 02/18/2010 |
| Last Update Date | 02/18/2010 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1083936033 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 103TH0100X | Psychologist - Health Service | (* (Not Available)) | Primary |
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