| Alta Healthcare Services, Inc. | |
|
101 Lakeforest Blvd Ste 250 Gaithersburg MD 20877-2633 | |
| (240) 801-9818 | |
| Not Available |
| Full Name | Alta Healthcare Services, Inc. |
|---|---|
| Speciality | Clinic/center - Mental Health (including Community Mental Health Center) |
| Location | 101 Lakeforest Blvd Ste 250, Gaithersburg, Maryland |
| Authorized Official Name and Position | Hannah Dibonge (ADMINISTRATOR) |
| Authorized Official Contact | 2405061728 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Alta Healthcare Services, Inc. 101 Lakeforest Blvd Ste 250 Gaithersburg MD 20877-2633 Ph: (240) 801-9818 | Alta Healthcare Services, Inc. 101 Lakeforest Blvd Ste 250 Gaithersburg MD 20877-2633 Ph: (240) 801-9818 |
| NPI Number | 1144877549 |
|---|---|
| Provider Enumeration Date | 08/20/2019 |
| Last Update Date | 08/20/2019 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1144877549 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 261QM0801X | Clinic/center - Mental Health (including Community Mental Health Center) | (* (Not Available)) | Primary |
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