1669470233 NPI number — A.C.E. HOME HEALTH CARE SERVICES INC

Table of Contents

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1669470233 NPI number — A.C.E. HOME HEALTH CARE SERVICES INC

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
A.C.E. HOME HEALTH CARE SERVICES INC
Provider Last Name:
Provider First Name:
Provider Middle Name:
Provider Name Prefix Text:
Provider Name Suffix Text:
Provider Credential Text:
Provider Gender Code:

Provider's Other Name Information

Provider Other Organization Name:
Provider Other Organization Name Type Code:
Provider Other Last Name:
Provider Other First Name:
Provider Other Middle Name:
Provider Other Name Prefix Text:
Provider Other Name Suffix Text:
Provider Other Credential Text:
Provider Other Last Name Type Code:

NPI Number Information

NPI Number:
1669470233
Entity Type Code:
Organization
Replacement NPI:
Last Update Date:
12/10/2019
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
PO BOX 499
Provider Second Line Business Mailing Address:
Provider Business Mailing Address City Name:
HOWARD CITY
Provider Business Mailing Address State Name:
MI
Provider Business Mailing Address Postal Code:
49329-0499
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
231-937-4514
Provider Business Mailing Address Fax Number:
231-937-7246

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
120 HEMLOCK ST
Provider Second Line Business Practice Location Address:
Provider Business Practice Location Address City Name:
HOWARD CITY
Provider Business Practice Location Address State Name:
MI
Provider Business Practice Location Address Postal Code:
49329-8859
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
231-937-4514
Provider Business Practice Location Address Fax Number:
231-937-7246
Provider Enumeration Date:
07/08/2005

Additional Information

Authorized Official

Authorized Official Last Name:
MYSELS
Authorized Official First Name:
ROBERTA
Authorized Official Middle Name:
LEE
Authorized Official Title or Position:
OWNER/PARTNER
Authorized Official Telephone Number:
231-937-4514

Provider Taxonomy Codes

  • Taxonomy code: 251E00000X , with the licence number:  237548 , registered in the state of MI ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

Other Provider's Identifiers (legacy, non-NPI)

  • Identifier: 154724143 , issued by the state of ( MI ) . This identifiers is of the category "MEDICAID".




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