Basic Information
| Provider Information | |||||||||
| NPI: | 1902471451 | ||||||||
| EntityType: | 2 | ||||||||
| ReplacementNPI: | |||||||||
| OrganizationName: | ALLIANCE KIDS CARE | ||||||||
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| Mailing Information | |||||||||
| Address1: | 6051 DAVIS BLVD # 821277 | ||||||||
| Address2: | |||||||||
| City: | N RICHLAND HILLS | ||||||||
| State: | TX | ||||||||
| PostalCode: | 761806385 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 8178512042 | ||||||||
| FaxNumber: | 8174053364 | ||||||||
| Practice Location | |||||||||
| Address1: | 1307 8TH AVE STE 310 | ||||||||
| Address2: | |||||||||
| City: | FORT WORTH | ||||||||
| State: | TX | ||||||||
| PostalCode: | 761044140 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 6823022237 | ||||||||
| FaxNumber: | 8174053364 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 05/26/2021 | ||||||||
| LastUpdateDate: | 05/26/2021 | ||||||||
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| AuthorizedOfficialLastName: | TAYLOR | ||||||||
| AuthorizedOfficialFirstName: | ANASTASIA | ||||||||
| AuthorizedOfficialMiddleName: | CHRISTINA | ||||||||
| AuthorizedOfficialTitleorPosition: | CEO / FOUNDER | ||||||||
| AuthorizedOfficialTelephone: | 6823022237 | ||||||||
| IsSoleProprietor: | |||||||||
| IsOrganizationSubpart: | Y | ||||||||
| ParentOrganizationLBN: | ALLIANCE CHILD & FAMILY SOLUTIONS | ||||||||
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| AuthorizedOfficialCredential: | LCSW-S | ||||||||
| NPICertificationDate: | 05/26/2021 | ||||||||
Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 101Y00000X | N | 193200000X MULTI-SPECIALTY GROUP | Behavioral Health & Social Service Providers | Counselor | 101YM0800X | N | 193200000X MULTI-SPECIALTY GROUP | Behavioral Health & Social Service Providers | Counselor | Mental Health | 101YP2500X | N | 193200000X MULTI-SPECIALTY GROUP | Behavioral Health & Social Service Providers | Counselor | Professional | 104100000X | N | 193200000X MULTI-SPECIALTY GROUP | Behavioral Health & Social Service Providers | Social Worker | 1041C0700X | Y | 193200000X MULTI-SPECIALTY GROUP | Behavioral Health & Social Service Providers | Social Worker | Clinical |
No ID Information.