Healthcare Provider Details

I. General information

NPI: 1275994824
Provider Name (Legal Business Name): ALTO BEHAVIORAL HEALTH SERVICES PLLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 03/10/2016
Last Update Date: 10/05/2023
Certification Date: 10/05/2023
Deactivation Date:
Reactivation Date:

III. Provider practice location address

827 LANSING SWITCH RD
LONGVIEW TX
75602-7102
US

IV. Provider business mailing address

510 E LOOP 281 STE B
LONGVIEW TX
75605-5076
US

V. Phone/Fax

Practice location:
  • Phone: 903-660-3053
  • Fax: 844-429-8648
Mailing address:
  • Phone: 903-475-2602
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code363LF0000X
TaxonomyFamily Nurse Practitioner
License NumberAP110100
License Number StateTX
# 2
Primary TaxonomyY
Taxonomy Code364SP0809X
TaxonomyAdult Psychiatric/Mental Health Clinical Nurse Specialist
License NumberAP110100
License Number StateTX

VIII. Authorized Official

Name: MS. ANNE E SHIELDS
Title or Position: DIRECTOR, SOLE PROPRIETOR
Credential: APRN
Phone: 903-475-2602