| Ally Mental Health, Llc | |
|
16270 Airline Hwy Ste D Prairieville LA 70769-4589 | |
| (225) 402-2299 | |
| (866) 258-9870 |
| Full Name | Ally Mental Health, Llc |
|---|---|
| Speciality | Clinic/Center |
| Location | 16270 Airline Hwy Ste D, Prairieville, Louisiana |
| Authorized Official Name and Position | Shantell Burns (OWNER) |
| Authorized Official Contact | 2254022299 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Ally Mental Health, Llc Po Box 1109 Prairieville LA 70769-1109 Ph: (225) 402-2299 | Ally Mental Health, Llc 16270 Airline Hwy Ste D Prairieville LA 70769-4589 Ph: (225) 402-2299 |
| NPI Number | 1205463254 |
|---|---|
| Provider Enumeration Date | 03/26/2020 |
| Last Update Date | 01/09/2024 |
| Certification Date | 01/09/2024 |
| Medicare PECOS PAC ID | 3678986973 |
|---|---|
| Medicare Enrollment ID | O20210105003265 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1205463254 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 261QM0801X | Clinic/center - Mental Health (including Community Mental Health Center) | (* (Not Available)) | Primary |
| Provider Name | Shantell Burns |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1003205931 PECOS PAC ID: 4587077888 Enrollment ID: I20210105003297 |
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