ALTA HEALTHCARE SERVICES LLC – NPI #1114674058
Clinic/Center

ALTA HEALTHCARE SERVICES LLC is an AHC clinic located in GAITHERSBURG, MD. NPPES has assigned the NPI number 1114674058 to ALTA HEALTHCARE SERVICES LLC on March 09, 2022. It is a Type-2 NPI, indicating this NPI number is associated with an organization. With multiple taxonomy codes selected, the primary taxonomy selected by this provider is 261QM0801X from the Health Care Provider Taxonomy code set, which is classified as Clinic/Center, specializing in Mental Health (Including Community Mental Health Center)

Use the NPI data found here to bill health insurance companies, identify providers enrolled in Medicare and Medicaid services or other HIPAA compliant transactions. See the complete NPI profile for ALTA HEALTHCARE SERVICES LLC below.

NPI Profile for
ALTA HEALTHCARE SERVICES LLC

NPI Number
1114674058
Enumeration Date

(more than 4 years ago)
Entity Type
Type-2  Organization
Organization health care providers may have a single employee or thousands of employees. An example is an incorporated individual who is an organization's only employee.
Legal Name
ALTA HEALTHCARE SERVICES LLC
Primary location
101 LAKEFOREST BLVD STE 250
GAITHERSBURG, MD 20877-2633
Phone: (240) 801-9818 Fax:
Mailing address
21506 MANOR VIEW CIR
GERMANTOWN, MD 20876-5924
Phone: (240) 506-1728 Fax:
Organization Subpart
No
Authorized Official
HANNAH DIBONGE
CEO
Phone: (240) 506-1728
Updated
Certification Date
Mar 09, 2022

Note: NPPES allows providers to attest to the accuracy of their NPI data. When a provider request any change to the NPI record, they will be able to attest to their changed NPI data, resulting in an updated certification date.

Taxonomy Code(s)

A taxonomy code is a code that describes the health care service provider's type, classification, and the area of specialization. The primary specialty for this provider is indicated as (Primary) below.

Taxonomy Classification / Specialization State License
261QM0801X
- Clinic/Center / Mental Health (Including Community Mental Health Center) (Primary)
261QR0405X
- Clinic/Center / Rehabilitation, Substance Use Disorder

The taxonomy codes are selected by the provider at the time of NPI registration. Selection of a taxonomy code does not replace any credentialing or validation process that the provider requesting the code should complete.