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General NPI Number Information
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NPI Number | 1639639982
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Entity Type | Organization
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Legal Business Name | ALIGN CARE, LLC
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Dates
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Enumeration Date | 03/22/2019
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Last Update Date | 07/27/2022
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Provider Practice Location Address
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Address Line | 3630 GRANADA AVE
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City | DALLAS
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State | TX
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Zip | 75205-2014
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Country | US
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Telephone | 903-521-1429
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Fax |
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Provider Business Mailing Address
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Address Line | 3630 GRANADA AVE
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City | DALLAS
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State | TX
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Zip | 75205-2014
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Country | US
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Telephone | 903-521-1429
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Fax |
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Authorized Official
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Title or Position | OWNER/PROGRAM MANAGER
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Name | KRYSTLE BICKNELL WOMACK
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Credential |
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Telephone | 903-521-1429
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 171W00000X
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Taxonomy Name | Contractor
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License Number |
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License Number State |
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Taxonomy #2
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Taxonomy Code | 251C00000X
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Taxonomy Name | Developmentally Disabled Services Day Training Agency
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License Number |
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Taxonomy #3
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Taxonomy Code | 251S00000X
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Taxonomy Name | Community/Behavioral Health Agency
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License Number |
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Taxonomy #4
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Taxonomy Code | 320900000X
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Taxonomy Name | Intellectual and/or Developmental Disabilities Community Based Residential Treatment Facility
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License Number |
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License Number State |
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Taxonomy #5
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Taxonomy Code | 251B00000X
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Taxonomy Name | Case Management Agency
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License Number |
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License Number State |
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