Provider Demographics
NPI:1619737202
Name:ALTHEC BEHAVIORAL HEALTH SERVICES LLC
Entity Type:Organization
Organization Name:ALTHEC BEHAVIORAL HEALTH SERVICES LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:LOVELINE
Authorized Official - Middle Name:
Authorized Official - Last Name:MENTONGA
Authorized Official - Suffix:
Authorized Official - Credentials:NP
Authorized Official - Phone:202-570-5518
Mailing Address - Street 1:7375 EXECUTIVE PL STE 100
Mailing Address - Street 2:
Mailing Address - City:LANHAM
Mailing Address - State:MD
Mailing Address - Zip Code:20706-6234
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:7375 EXECUTIVE PL STE 100
Practice Address - Street 2:
Practice Address - City:LANHAM
Practice Address - State:MD
Practice Address - Zip Code:20706-6234
Practice Address - Country:US
Practice Address - Phone:202-570-5518
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2024-03-20
Last Update Date:2024-03-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes363LP0808XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerPsychiatric/Mental HealthGroup - Multi-Specialty