Provider Demographics
NPI:1225851124
Name:KALEA WELLNESS PLLC
Entity type:Organization
Organization Name:KALEA WELLNESS PLLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:THALIA
Authorized Official - Middle Name:
Authorized Official - Last Name:TONCHE
Authorized Official - Suffix:
Authorized Official - Credentials:LPC
Authorized Official - Phone:325-665-7731
Mailing Address - Street 1:609 STRADA CIR STE 123
Mailing Address - Street 2:
Mailing Address - City:MANSFIELD
Mailing Address - State:TX
Mailing Address - Zip Code:76063-6639
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:609 STRADA CIR STE 123
Practice Address - Street 2:
Practice Address - City:MANSFIELD
Practice Address - State:TX
Practice Address - Zip Code:76063-6639
Practice Address - Country:US
Practice Address - Phone:325-665-7731
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2024-11-07
Last Update Date:2024-11-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QM0801XAmbulatory Health Care FacilitiesClinic/CenterMental Health (Including Community Mental Health Center)