Alta Healthcare Services LLC
Clinic/Center, Mental Health (Including Community Mental Health Center) in Gaithersburg, MD. Organization (NPI-2).
NPI number1114674058
StatusActive
Last updated in NPPESMar 9, 2022
Details
- NPI
- 1114674058
- Entity type
- Organization (NPI-2)
- Legal business name
- Alta Healthcare Services LLC
- Organization subpart
- No
- Enumeration date
- Mar 9, 2022
- Certification date
- Mar 9, 2022
- Last updated
- Mar 9, 2022
Taxonomy and licenses
| Taxonomy code | Description | License | State | Primary |
|---|---|---|---|---|
| 261QM0801X | Clinic/Center, Mental Health (Including Community Mental Health Center) | – | – | Yes |
| 261QR0405X | Clinic/Center, Rehabilitation, Substance Use Disorder | – | – |
Practice location
101 Lakeforest Blvd Ste 250Gaithersburg, MD 20877-2633
Phone 240-801-9818
Mailing address
21506 Manor View CirGermantown, MD 20876-5924
Phone 240-506-1728
Authorized official
Hannah Dibonge
Ceo
2405061728
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