Provider Demographics
NPI:1780206631
Name:CAPROCK ALLIANCE FOR MENTAL WELLNESS, PLLC
Entity Type:Organization
Organization Name:CAPROCK ALLIANCE FOR MENTAL WELLNESS, PLLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER/PROVIDER
Authorized Official - Prefix:
Authorized Official - First Name:STACY
Authorized Official - Middle Name:ALLISON
Authorized Official - Last Name:HOBBS
Authorized Official - Suffix:
Authorized Official - Credentials:MSN, APRN, PMHNP-BC
Authorized Official - Phone:806-412-4489
Mailing Address - Street 1:5 RITCHIE RD
Mailing Address - Street 2:
Mailing Address - City:WACO
Mailing Address - State:TX
Mailing Address - Zip Code:76712-8555
Mailing Address - Country:US
Mailing Address - Phone:806-412-4489
Mailing Address - Fax:806-412-4489
Practice Address - Street 1:2844 MACKEY RANCH RD
Practice Address - Street 2:
Practice Address - City:MOODY
Practice Address - State:TX
Practice Address - Zip Code:76557-4182
Practice Address - Country:US
Practice Address - Phone:806-412-4489
Practice Address - Fax:806-412-4489
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2020-05-14
Last Update Date:2021-04-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes363LP0808XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerPsychiatric/Mental HealthGroup - Single Specialty