Provider Demographics
NPI:1760167290
Name:ALS WELLNESS, MARRIAGE & FAMILY THERAPY INC
Entity Type:Organization
Organization Name:ALS WELLNESS, MARRIAGE & FAMILY THERAPY INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER/CEO
Authorized Official - Prefix:
Authorized Official - First Name:AMBER
Authorized Official - Middle Name:
Authorized Official - Last Name:SALDATE-STUBBS
Authorized Official - Suffix:
Authorized Official - Credentials:LMFT
Authorized Official - Phone:559-801-1480
Mailing Address - Street 1:5593 N 6TH ST
Mailing Address - Street 2:
Mailing Address - City:FRESNO
Mailing Address - State:CA
Mailing Address - Zip Code:93710-6356
Mailing Address - Country:US
Mailing Address - Phone:559-240-2709
Mailing Address - Fax:
Practice Address - Street 1:5151 N PALM AVE STE 750
Practice Address - Street 2:
Practice Address - City:FRESNO
Practice Address - State:CA
Practice Address - Zip Code:93704-2221
Practice Address - Country:US
Practice Address - Phone:559-801-1480
Practice Address - Fax:559-785-0046
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2023-06-21
Last Update Date:2023-06-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental HealthGroup - Single Specialty
No261QM0801XAmbulatory Health Care FacilitiesClinic/CenterMental Health (Including Community Mental Health Center)Group - Single Specialty