MEDICARE: ACES, INC

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	251S00000X	Community/Behavioral Health Agency
2	104100000X	Social Worker

General Provider Information

NPI Number	:	1396163275
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	ACES, INC

Provider Business Mailing Address
First Line	:	5583 N GLENWOOD ST
Second Line	:
City	:	GARDEN CITY
State	:	ID
Zip	:	83714-1336
Country	:	US
Telephone Number	:	208-287-2564
Fax Number	:	208-287-2570

Provider Business Practice Location Address
First Line	:	5583 N GLENWOOD ST
Second Line	:
City	:	GARDEN CITY
State	:	ID
Zip	:	83714-1336
Country	:	US
Telephone Number	:	208-287-2564
Fax Number	:	208-287-2570

Authorized Official
Title or Position	:	OWNER
Name	:	DON GROSS
Credential	:
Telephone Number	:	208-287-2564

Provider Enumeration Date	:	03/28/2014
Last Update Date	:	03/28/2014

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Directions to “ACES, INC ” Practice Location

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