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General NPI Number Information
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NPI Number | 1245568930
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Entity Type | Organization
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Legal Business Name | ACE-AGENCY FOR COMMUNITY EMPOWERMENT , INC.
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Dates
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Enumeration Date | 11/18/2009
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Last Update Date | 09/25/2013
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Provider Practice Location Address
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Address Line | 5730 BOWDEN RD SUITE 206
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City | JACKSONVILLE
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State | FL
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Zip | 32216-6104
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Country | US
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Telephone | 904-551-0760
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Fax |
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Provider Business Mailing Address
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Address Line | 5730 BOWDEN RD SUITE 206
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City | JACKSONVILLE
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State | FL
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Zip | 32216-6104
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Country | US
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Telephone | 904-551-0760
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Fax |
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Authorized Official
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Title or Position | VICE PRESIDENT/TREASURER OF BOD
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Name | MRS. BRENDA LEIGH SHEPHARD
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Credential |
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Telephone | 904-551-0760
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 251B00000X
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Taxonomy Name | Case Management Agency
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License Number |
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License Number State |
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Taxonomy #2
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Taxonomy Code | 253Z00000X
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Taxonomy Name | In Home Supportive Care Agency
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License Number |
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License Number State |
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Taxonomy #3
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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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