Organization
ALTA HEALTHCARE SERVICES LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
HANNAH DIBONGE (CEO)
(240) 506-1728
Entity
Organization
Contact information
Practice address
101 LAKEFOREST BLVD STE 250, GAITHERSBURG, MD 20877-2633
(240) 801-9818
Mailing address
21506 MANOR VIEW CIR, GERMANTOWN, MD 20876-5924
(240) 506-1728
Taxonomy
Speciality
Code
Description
License number
State
261QM0801X
Mental Health Clinic/Center (Including Community Mental Health Center)
Primary
—
—
261QR0405X
Substance Use Disorder Rehabilitation Clinic/Center
—
—
Other
Enumeration date
03/09/2022
Last updated
03/09/2022
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