Healthcare Provider Details

I. General information

NPI: 1205369980
Provider Name (Legal Business Name): ALLIANCE COUNSELING AND EDUCATION SERVICES
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 04/10/2017
Last Update Date: 04/10/2017
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

959 SE 2ND AVE 254
DEERFIELD BEACH FL
33441-5573
US

IV. Provider business mailing address

440 S FEDERAL HWY SUITE 103
DEERFIELD BEACH FL
33441-4114
US

V. Phone/Fax

Practice location:
  • Phone: 773-676-4956
  • Fax:
Mailing address:
  • Phone: 773-676-4956
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code261QM0801X
TaxonomyMental Health Clinic/Center (Including Community Mental Health Center)
License Number251S00000X
License Number StateFL

VIII. Authorized Official

Name: RAMON NOLASCO
Title or Position: CEO
Credential: LMHC
Phone: 773-676-4956