Provider Demographics
NPI:1326261322
Name:ALAMO REGION ALTERNATIVE REHAB CTR.
Entity Type:Organization
Organization Name:ALAMO REGION ALTERNATIVE REHAB CTR.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CEO
Authorized Official - Prefix:
Authorized Official - First Name:ALAN
Authorized Official - Middle Name:WALKER
Authorized Official - Last Name:YOUNG
Authorized Official - Suffix:
Authorized Official - Credentials:DO
Authorized Official - Phone:210-696-5858
Mailing Address - Street 1:225 E SONTERRA BLVD STE 206
Mailing Address - Street 2:
Mailing Address - City:SAN ANTONIO
Mailing Address - State:TX
Mailing Address - Zip Code:78258-3994
Mailing Address - Country:US
Mailing Address - Phone:210-696-5858
Mailing Address - Fax:210-558-4464
Practice Address - Street 1:225 E SONTERRA BLVD STE 206
Practice Address - Street 2:
Practice Address - City:SAN ANTONIO
Practice Address - State:TX
Practice Address - Zip Code:78258-3994
Practice Address - Country:US
Practice Address - Phone:210-696-5858
Practice Address - Fax:210-558-4464
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-04-10
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes174400000XOther Service ProvidersSpecialistGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
TXE51615Medicare UPIN
TXOOF28PMedicare ID - Type Unspecified