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NPI 1144587866

NPI 1144587866 : ACE ENRICHMENT SERVICES, INC. : WHITEVILLE, NC

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General NPI Number Information
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    NPI Number           |    1144587866
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    Entity Type          |    Organization 
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    Legal Business Name  |    ACE ENRICHMENT SERVICES, INC. 
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Dates
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    Enumeration Date     |    04/19/2012
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    Last Update Date     |    04/19/2012
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Provider Practice Location Address
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    Address Line         |    204 W VIRGIL ST 
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    City                 |    WHITEVILLE
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    State                |    NC
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    Zip                  |    28472-4018
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    Country              |    US
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    Telephone            |    910-918-8094
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    Fax                  |    
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Provider Business Mailing Address
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    Address Line         |    204 WEST VIRGIL ST. 
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    City                 |    WHITEVILLE
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    State                |    NC
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    Zip                  |    28472-8563
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    Country              |    US
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    Telephone            |    910-918-8094
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    Fax                  |    
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Authorized Official
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    Title or Position    |    OWNER, CEO
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    Name                 |     RAY C. JACOBS JR.
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    Credential           |    
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    Telephone            |    910-918-5707
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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    Taxonomy Code        |    251S00000X
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    Taxonomy Name        |    Community/Behavioral Health Agency
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    License Number       |    
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    License Number State |    
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