| Ally Behavioral Health Services Inc | |
|
8700 Central Ave Ste 308 Landover MD 20785-4853 | |
| (301) 825-4059 | |
| Not Available |
| Full Name | Ally Behavioral Health Services Inc |
|---|---|
| Speciality | Clinic/Center |
| Location | 8700 Central Ave Ste 308, Landover, Maryland |
| Authorized Official Name and Position | Christopher Tayo Titus (CEO) |
| Authorized Official Contact | 3018254059 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Ally Behavioral Health Services Inc 15202 Emily Ct Bowie MD 20716-3200 Ph: (301) 825-4059 | Ally Behavioral Health Services Inc 8700 Central Ave Ste 308 Landover MD 20785-4853 Ph: (301) 825-4059 |
| NPI Number | 1770056541 |
|---|---|
| Provider Enumeration Date | 01/04/2019 |
| Last Update Date | 09/23/2022 |
| Certification Date | 09/23/2022 |
| Medicare PECOS PAC ID | 1658763297 |
|---|---|
| Medicare Enrollment ID | O20220112000024 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1770056541 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 261QM0801X | Clinic/center - Mental Health (including Community Mental Health Center) | (* (Not Available)) | Primary |
| Provider Name | Regine Chokote |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1528654977 PECOS PAC ID: 9638561277 Enrollment ID: I20220112000082 |
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