Healthcare Provider Details

I. General information

NPI: 1902227069
Provider Name (Legal Business Name): ACE'S BEHAVIORAL HEALTH SERVICE
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 12/17/2013
Last Update Date: 12/17/2013
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

5708 ARROW TREE ST
LAS VEGAS NV
89130-7277
US

IV. Provider business mailing address

5708 ARROW TREE ST
LAS VEGAS NV
89130-7277
US

V. Phone/Fax

Practice location:
  • Phone: 702-577-6266
  • Fax:
Mailing address:
  • Phone: 702-577-6266
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code251C00000X
TaxonomyDevelopmentally Disabled Services Day Training Agency
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code251S00000X
TaxonomyCommunity/Behavioral Health Agency
License Number
License Number State

VIII. Authorized Official

Name: WILLIE HENRY
Title or Position: PRESIDENT
Credential:
Phone: 702-577-6866