Provider Demographics
NPI:1073835625
Name:AGENCY FOR COMMUNITY EMPOWERMENT ACE
Entity Type:Organization
Organization Name:AGENCY FOR COMMUNITY EMPOWERMENT ACE
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:DIRECTOR OF FINANCE
Authorized Official - Prefix:MRS
Authorized Official - First Name:BRENDA
Authorized Official - Middle Name:LEIGH
Authorized Official - Last Name:SHEPHARD
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:904-551-0760
Mailing Address - Street 1:5730 BOWDEN RD STE 206
Mailing Address - Street 2:
Mailing Address - City:JACKSONVILLE
Mailing Address - State:FL
Mailing Address - Zip Code:32216-6103
Mailing Address - Country:US
Mailing Address - Phone:904-551-0760
Mailing Address - Fax:904-745-3793
Practice Address - Street 1:5730 BOWDEN RD STE 206
Practice Address - Street 2:
Practice Address - City:JACKSONVILLE
Practice Address - State:FL
Practice Address - Zip Code:32216
Practice Address - Country:US
Practice Address - Phone:904-551-0760
Practice Address - Fax:904-745-3793
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2010-02-24
Last Update Date:2018-05-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FL251B00000X, 251S00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251S00000XAgenciesCommunity/Behavioral Health
No251B00000XAgenciesCase Management