Provider Demographics
NPI:1316771348
Name:ALLIANCE BEHAVIORAL HEALTH LLC
Entity type:Organization
Organization Name:ALLIANCE BEHAVIORAL HEALTH LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:MANAGER
Authorized Official - Prefix:
Authorized Official - First Name:ALBERT
Authorized Official - Middle Name:
Authorized Official - Last Name:PEPRAH
Authorized Official - Suffix:
Authorized Official - Credentials:DNP
Authorized Official - Phone:508-970-6942
Mailing Address - Street 1:8 THE GRN STE A
Mailing Address - Street 2:
Mailing Address - City:DOVER
Mailing Address - State:DE
Mailing Address - Zip Code:19901-3618
Mailing Address - Country:US
Mailing Address - Phone:508-615-8569
Mailing Address - Fax:
Practice Address - Street 1:9 HAMMOND ST
Practice Address - Street 2:
Practice Address - City:WORCESTER
Practice Address - State:MA
Practice Address - Zip Code:01610-1512
Practice Address - Country:US
Practice Address - Phone:508-970-6942
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2024-08-30
Last Update Date:2024-08-31
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QM0801XAmbulatory Health Care FacilitiesClinic/CenterMental Health (Including Community Mental Health Center)