Organization
ALTA HEALTCARE SERVICES
Active
Organization subpart
No
Provider details
NPI number
Authorized official
HANNAH DIBONGE PHARMD (OWNER)
(240) 506-1728
Entity
Organization
Contact information
Practice address
101 LAKEFOREST BLVD STE 250, GAITHERSBURG, MD 20877-2633
(240) 506-1728
Mailing address
21506 MANOR VIEW CIR, GERMANTOWN, MD 20876-5924
Taxonomy
Speciality
Code
Description
License number
State
251S00000X
Community/Behavioral Health Agency
Primary
MH-2371
MD
Other
Enumeration date
10/24/2017
Last updated
06/16/2018
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