MEDICARE: ALIGN CARE, LLC

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy
1	171W00000X	Contractor
2	251C00000X	Developmentally Disabled Services Day Training Agency
3	251S00000X	Community/Behavioral Health Agency
4	320900000X	Intellectual and/or Developmental Disabilities Community Based Residential Treatment Facility
5	251B00000X	Case Management Agency

General Provider Information

NPI Number	:	1639639982
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	ALIGN CARE, LLC

Provider Business Mailing Address
First Line	:	3630 GRANADA AVE
Second Line	:
City	:	DALLAS
State	:	TX
Zip	:	75205-2014
Country	:	US
Telephone Number	:	903-521-1429
Fax Number	:

Provider Business Practice Location Address
First Line	:	3630 GRANADA AVE
Second Line	:
City	:	DALLAS
State	:	TX
Zip	:	75205-2014
Country	:	US
Telephone Number	:	903-521-1429
Fax Number	:

Authorized Official
Title or Position	:	OWNER/PROGRAM MANAGER
Name	:	KRYSTLE BICKNELL WOMACK
Credential	:
Telephone Number	:	903-521-1429

Provider Enumeration Date	:	03/22/2019
Last Update Date	:	07/27/2022

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Directions to “ALIGN CARE, LLC ” Practice Location

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