Provider Demographics
NPI:1023431483
Name:ALAMO AREA COUNCIL OF GOVERNMENTS
Entity type:Organization
Organization Name:ALAMO AREA COUNCIL OF GOVERNMENTS
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:EXECUTIVE DIRECTOR
Authorized Official - Prefix:MR
Authorized Official - First Name:CLIFFORD
Authorized Official - Middle Name:
Authorized Official - Last Name:HERBERG
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:210-362-5200
Mailing Address - Street 1:2700 NE LOOP 410 STE 101
Mailing Address - Street 2:
Mailing Address - City:SAN ANTONIO
Mailing Address - State:TX
Mailing Address - Zip Code:78217-4841
Mailing Address - Country:US
Mailing Address - Phone:210-362-5200
Mailing Address - Fax:866-332-3252
Practice Address - Street 1:2700 NE LOOP 410 STE 101
Practice Address - Street 2:
Practice Address - City:SAN ANTONIO
Practice Address - State:TX
Practice Address - Zip Code:78217-4840
Practice Address - Country:US
Practice Address - Phone:210-362-5200
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:ALAMO AREA COUNCIL OF GOVERNMENTS
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2014-01-21
Last Update Date:2024-01-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX11478103TB0200X, 103TC1900X
103T00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes103T00000XBehavioral Health & Social Service ProvidersPsychologistGroup - Multi-Specialty
No103TB0200XBehavioral Health & Social Service ProvidersPsychologistCognitive & BehavioralGroup - Multi-Specialty
No103TC1900XBehavioral Health & Social Service ProvidersPsychologistCounselingGroup - Multi-Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX1538227152Medicaid
TXTXB156793Medicare PIN