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General NPI Number Information
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NPI Number | 1780206631
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Entity Type | Organization
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Legal Business Name | CAPROCK ALLIANCE FOR MENTAL WELLNESS, PLLC
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Dates
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Enumeration Date | 05/14/2020
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Last Update Date | 04/28/2021
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Provider Practice Location Address
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Address Line | 2844 MACKEY RANCH RD
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City | MOODY
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State | TX
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Zip | 76557-4182
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Country | US
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Telephone | 806-412-4489
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Fax | 806-412-4489
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Provider Business Mailing Address
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Address Line | 5 RITCHIE RD
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City | WACO
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State | TX
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Zip | 76712-8555
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Country | US
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Telephone | 806-412-4489
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Fax | 806-412-4489
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Authorized Official
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Title or Position | OWNER/PROVIDER
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Name | STACY ALLISON HOBBS
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Credential | MSN, APRN, PMHNP-BC
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Telephone | 806-412-4489
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 363LP0808X
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Taxonomy Name | Psychiatric/Mental Health Nurse Practitioner
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License Number |
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License Number State |
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