Healthcare Provider Details

I. General information

NPI: 1255905576
Provider Name (Legal Business Name): ALIRA BEHAVIORAL HEALTH, LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 05/20/2021
Last Update Date: 02/19/2026
Certification Date: 02/19/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

867 BOYLSTON ST FL 5
BOSTON MA
02116-2774
US

IV. Provider business mailing address

867 BOYLSTON ST FL 5
BOSTON MA
02116-2774
US

V. Phone/Fax

Practice location:
  • Phone: 508-466-5919
  • Fax: 508-213-3691
Mailing address:
  • Phone: 470-947-2240
  • Fax: 470-947-2769

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code261QM0801X
TaxonomyMental Health Clinic/Center (Including Community Mental Health Center)
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code363LF0000X
TaxonomyFamily Nurse Practitioner
License Number
License Number State
# 3
Primary TaxonomyN
Taxonomy Code363LP0808X
TaxonomyPsychiatric/Mental Health Nurse Practitioner
License Number
License Number State
# 4
Primary TaxonomyN
Taxonomy Code363LW0102X
TaxonomyWomen's Health Nurse Practitioner
License Number
License Number State

VIII. Authorized Official

Name: LAYWELL TEDOE
Title or Position: OWNER
Credential: DNP, APRN
Phone: 470-870-2620