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General NPI Number Information
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NPI Number | 1568232239
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Entity Type | Organization
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Legal Business Name | ACE HOLISTIC SUPPORT INC
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Dates
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Enumeration Date | 01/04/2024
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Last Update Date | 01/04/2024
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Provider Practice Location Address
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Address Line | 11720 BELTSVILLE DR STE 500-A5
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City | BELTSVILLE
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State | MD
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Zip | 20705-3166
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Country | US
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Telephone | 667-392-3765
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Fax | 240-540-6170
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Provider Business Mailing Address
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Address Line | 11720 BELTSVILLE DR STE 500-A5
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City | BELTSVILLE
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State | MD
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Zip | 20705-3166
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Country | US
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Telephone | 667-392-3765
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Fax | 240-540-6170
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Authorized Official
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Title or Position | CEO
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Name | EPHRAIM A MAKINDE
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Credential | PMHNP-BC
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Telephone | 240-421-1251
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 251C00000X
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Taxonomy Name | Developmentally Disabled Services Day Training Agency
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License Number |
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License Number State |
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