Provider Demographics
NPI:1427387901
Name:ALEK'S HOUSE LLC
Entity type:Organization
Organization Name:ALEK'S HOUSE LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:MRS
Authorized Official - First Name:NICOLA
Authorized Official - Middle Name:
Authorized Official - Last Name:DAVIS
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:301-731-0383
Mailing Address - Street 1:4200 FORBES BLVD
Mailing Address - Street 2:SUITE 122
Mailing Address - City:LANHAM
Mailing Address - State:MD
Mailing Address - Zip Code:20706-4342
Mailing Address - Country:US
Mailing Address - Phone:301-731-0383
Mailing Address - Fax:301-731-2835
Practice Address - Street 1:4200 FORBES BLVD
Practice Address - Street 2:SUITE 122
Practice Address - City:LANHAM
Practice Address - State:MD
Practice Address - Zip Code:20706-4342
Practice Address - Country:US
Practice Address - Phone:301-429-6100
Practice Address - Fax:301-429-1333
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2009-12-14
Last Update Date:2009-12-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QM0855XAmbulatory Health Care FacilitiesClinic/CenterAdolescent and Children Mental Health
Provider Identifiers
StateIdentifier IDID TypeIssuer
MD415169101Medicaid
MD415169100Medicaid
MD415169102Medicaid
MD415169101Medicaid