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General NPI Number Information
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NPI Number | 1417403916
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Entity Type | Organization
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Legal Business Name | ALPHA ALLIED MENTAL HEALTH SERVICES
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Dates
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Enumeration Date | 08/25/2016
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Last Update Date | 08/25/2016
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Provider Practice Location Address
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Address Line | 699 WALNUT ST STE 400
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City | DES MOINES
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State | IA
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Zip | 50309-3962
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Country | US
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Telephone | 217-257-0740
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Fax |
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Provider Business Mailing Address
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Address Line | 699 WALNUT ST STE 400
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City | DES MOINES
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State | IA
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Zip | 50309-3962
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Country | US
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Telephone | 217-257-0740
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Fax |
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Authorized Official
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Title or Position | OWNER
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Name | MR. QUENTIN CHAMBERS
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Credential | N.P
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Telephone | 217-257-0740
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 363LP0808X
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Taxonomy Name | Psychiatric/Mental Health Nurse Practitioner
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License Number | G139841
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License Number State | IA
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