Ally Supportive Services, LLC

Primary specialty

Community/Behavioral Health AgencyTaxonomy code 251S00000X

Legal business name

ALLY SUPPORTIVE SERVICES, LLC

Practice address

245 Marie Ave E Ste 107
West St Paul, MN 55118-4280

Phone

(651) 302-4471

NPI assigned

Feb 17, 2021

Organization subpart

No

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

Authorized official

Name

Nathan Tonnancour

Title

Chief Manager

Phone

(651) 302-4471

Specialties & licenses 1

Addresses

Other identifiers 1

Locations

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

{
    "created_epoch": "1613520000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1613520000000",
    "number": "1407449846",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 544",
            "city": "SOUTH ST PAUL",
            "state": "MN",
            "postal_code": "550750544",
            "telephone_number": "651-302-4471",
            "fax_number": "651-760-4334"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "245 MARIE AVE E STE 107",
            "city": "WEST ST PAUL",
            "state": "MN",
            "postal_code": "551184280",
            "telephone_number": "651-302-4471"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "ALLY SUPPORTIVE SERVICES, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2021-02-17",
        "last_updated": "2021-02-17",
        "certification_date": "2021-02-17",
        "status": "A",
        "authorized_official_last_name": "TONNANCOUR",
        "authorized_official_first_name": "NATHAN",
        "authorized_official_title_or_position": "CHIEF MANAGER",
        "authorized_official_telephone_number": "651-302-4471"
    },
    "taxonomies": [
        {
            "code": "251S00000X",
            "taxonomy_group": "",
            "desc": "Community/Behavioral Health",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "STATE OF MINNESOTA",
            "identifier": "A720082300",
            "state": "MN"
        }
    ],
    "endpoints": [],
    "other_names": []
}

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• Community/Behavioral Health Agency in Minnesota

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 17, 2021; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.