Alta Healthcare Services, Inc.

Primary specialty

Mental Health Clinic/Center (Including Community Mental Health Center)Taxonomy code 261QM0801X

Legal business name

ALTA HEALTHCARE SERVICES, INC.

Practice address

101 Lakeforest Blvd Ste 250
Gaithersburg, MD 20877-2633

Phone

(240) 801-9818

NPI assigned

Aug 20, 2019

Organization subpart

No

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name

Hannah Dibonge

Title

Administrator

Phone

(240) 506-1728

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in DC

Enrollment records 1

Other NPIs on the same Medicare enrollment 1

NPIs listed together on one Medicare enrollment, typically parts of the same organization.

• Alta Healthcare Services, Inc.

  • Rehabilitation Clinic/Center
  • Gaithersburg, MD
  • NPI 1821789389

  O20200319000078

  Same enrollment

Locations

Practitioners 2

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

• Evlyn Esiet Billy-Eko, PMHNP-BC

  • Psychiatric/Mental Health Nurse Practitioner
  • Catonsville, MD
  • NPI 1427756584
  NPD
• Kasheria Nadra West, PMHNP

  • Psychiatric/Mental Health Nurse Practitioner
  • Columbia, MD
  • NPI 1790475325
  NPD

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1566259200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1566259200000",
    "number": "1144877549",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "101 LAKEFOREST BLVD STE 250",
            "city": "GAITHERSBURG",
            "state": "MD",
            "postal_code": "208772633",
            "telephone_number": "240-801-9818"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "101 LAKEFOREST BLVD STE 250",
            "city": "GAITHERSBURG",
            "state": "MD",
            "postal_code": "208772633",
            "telephone_number": "240-801-9818"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "ALTA HEALTHCARE SERVICES, INC.",
        "organizational_subpart": "NO",
        "enumeration_date": "2019-08-20",
        "last_updated": "2019-08-20",
        "status": "A",
        "authorized_official_last_name": "DIBONGE",
        "authorized_official_first_name": "HANNAH",
        "authorized_official_title_or_position": "ADMINISTRATOR",
        "authorized_official_telephone_number": "240-506-1728"
    },
    "taxonomies": [
        {
            "code": "261QM0801X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Mental Health (Including Community Mental Health Center)",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Alta Healtcare Services
• Alta Healthcare Services LLC
• Alta Healthcare Services LLC
• Alta Healthcare Services LLC
• Alta Healthcare Services LLC
• Alta Healthcare Services, Inc.
• Alta Healthcare Services, Inc.
• Altes Home Care LLC
• Ashley L Alvarado, LMSW
• Nicole Alvarez de Rivera

• Mental Health Clinic/Center (Including Community Mental Health Center) in Gaithersburg, MD
• Providers in Gaithersburg, MD by specialty
• Mental Health Clinic/Center (Including Community Mental Health Center) in Maryland

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 20, 2019; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.