Provider Demographics
NPI:1952778490
Name:ALAMO WELLNESS GROUP, LLC
Entity type:Organization
Organization Name:ALAMO WELLNESS GROUP, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:VALERIE
Authorized Official - Middle Name:
Authorized Official - Last Name:MOCZYGEMBA
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:210-293-0883
Mailing Address - Street 1:11230 WEST AVE STE 1105
Mailing Address - Street 2:
Mailing Address - City:SAN ANTONIO
Mailing Address - State:TX
Mailing Address - Zip Code:78213-1359
Mailing Address - Country:US
Mailing Address - Phone:210-293-0883
Mailing Address - Fax:
Practice Address - Street 1:11230 WEST AVE STE 1105
Practice Address - Street 2:
Practice Address - City:SAN ANTONIO
Practice Address - State:TX
Practice Address - Zip Code:78213-1359
Practice Address - Country:US
Practice Address - Phone:210-293-0883
Practice Address - Fax:210-352-9210
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2015-09-01
Last Update Date:2024-12-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessionalGroup - Multi-Specialty
No101YM0800XBehavioral Health & Social Service ProvidersCounselorMental HealthGroup - Multi-Specialty