MEDICARE: ALLY HEALTH NURSING AND MEDICAL SERVICES INC

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	261QM0801X	Mental Health Clinic/Center (Including Community Mental Health Center)

General Provider Information

NPI Number	:	1770056541
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	ALLY HEALTH NURSING AND MEDICAL SERVICES INC

Provider Business Mailing Address
First Line	:	15202 EMILY CT
Second Line	:
City	:	BOWIE
State	:	MD
Zip	:	20716-3200
Country	:	US
Telephone Number	:	301-825-4059
Fax Number	:

Provider Business Practice Location Address
First Line	:	8700 CENTRAL AVE STE 308
Second Line	:
City	:	LANDOVER
State	:	MD
Zip	:	20785-4853
Country	:	US
Telephone Number	:	301-825-4059
Fax Number	:

Authorized Official
Title or Position	:	CEO
Name	:	CHRISTOPHER TAYO TITUS
Credential	:
Telephone Number	:	301-825-4059

Provider Enumeration Date	:	01/04/2019
Last Update Date	:	09/23/2022

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