Healthcare Provider Details

I. General information

NPI: 1427387901
Provider Name (Legal Business Name): ALEK'S HOUSE LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 12/14/2009
Last Update Date: 12/16/2009
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

4200 FORBES BLVD SUITE 122
LANHAM MD
20706-4342
US

IV. Provider business mailing address

4200 FORBES BLVD SUITE 122
LANHAM MD
20706-4342
US

V. Phone/Fax

Practice location:
  • Phone: 301-429-6100
  • Fax: 301-429-1333
Mailing address:
  • Phone: 301-731-0383
  • Fax: 301-731-2835

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code261QM0855X
TaxonomyAdolescent and Children Mental Health Clinic/Center
License Number
License Number State

VIII. Authorized Official

Name: MRS. NICOLA DAVIS
Title or Position: OWNER
Credential:
Phone: 301-731-0383