Healthcare Provider Details

I. General information

NPI: 1609973577
Provider Name (Legal Business Name): ACES INC.
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 09/20/2006
Last Update Date: 02/07/2013
Certification Date:
Deactivation Date: 03/09/2011
Reactivation Date: 10/31/2011

III. Provider practice location address

890 N COLE RD
BOISE ID
83704-8638
US

IV. Provider business mailing address

5583 N GLENWOOD ST
GARDEN CITY ID
83714-1336
US

V. Phone/Fax

Practice location:
  • Phone: 208-322-1026
  • Fax: 208-322-1029
Mailing address:
  • Phone: 208-287-2564
  • Fax: 208-287-2570

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code101YP2500X
TaxonomyProfessional Counselor
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code251S00000X
TaxonomyCommunity/Behavioral Health Agency
License Number
License Number State
# 3
Primary TaxonomyY
Taxonomy Code1041C0700X
TaxonomyClinical Social Worker
License Number
License Number State

VIII. Authorized Official

Name: DONALD D GROSS
Title or Position: PRESIDENT
Credential:
Phone: 208-619-0190