Provider Demographics
NPI:1194450189
Name:ALIGN GROUP HOME LLC
Entity type:Organization
Organization Name:ALIGN GROUP HOME LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:ADMINISTRATOR
Authorized Official - Prefix:
Authorized Official - First Name:BENATBRAGEN
Authorized Official - Middle Name:NKWANYOU
Authorized Official - Last Name:ARREY
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:480-707-1824
Mailing Address - Street 1:22264 EAST PECAN LANE
Mailing Address - Street 2:
Mailing Address - City:QUEEN CREEK
Mailing Address - State:AZ
Mailing Address - Zip Code:85142
Mailing Address - Country:US
Mailing Address - Phone:480-707-1824
Mailing Address - Fax:480-597-4007
Practice Address - Street 1:22264 EAST PECAN LANE
Practice Address - Street 2:
Practice Address - City:QUEEN CREEK
Practice Address - State:AZ
Practice Address - Zip Code:85142
Practice Address - Country:US
Practice Address - Phone:480-707-1824
Practice Address - Fax:480-597-4007
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:ALIGN GROUP HOME LLC
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2022-07-22
Last Update Date:2022-08-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes320800000XResidential Treatment FacilitiesCommunity Based Residential Treatment Facility, Mental Illness