Provider Demographics
NPI:1508157173
Name:ALTERNATIVE COMMUNITY ENRICHMENT SERVICES, INC
Entity Type:Organization
Organization Name:ALTERNATIVE COMMUNITY ENRICHMENT SERVICES, INC
Other - Org Name:ACES COMMUNITY SERVICES, INC
Other - Org Type:Doing Business As
Authorized Official - Title/Position:OPERATIONS MANAGER
Authorized Official - Prefix:MRS
Authorized Official - First Name:MICHELLE
Authorized Official - Middle Name:
Authorized Official - Last Name:WOOD
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:208-292-2188
Mailing Address - Street 1:1417 N 4TH ST
Mailing Address - Street 2:
Mailing Address - City:COEUR D ALENE
Mailing Address - State:ID
Mailing Address - Zip Code:83814-3310
Mailing Address - Country:US
Mailing Address - Phone:208-292-2188
Mailing Address - Fax:208-292-2189
Practice Address - Street 1:1602 E SELTICE WAY STE D
Practice Address - Street 2:
Practice Address - City:POST FALLS
Practice Address - State:ID
Practice Address - Zip Code:83854-7082
Practice Address - Country:US
Practice Address - Phone:208-292-2188
Practice Address - Fax:208-292-2189
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2011-04-29
Last Update Date:2011-04-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
ID251S00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251S00000XAgenciesCommunity/Behavioral Health
Provider Identifiers
StateIdentifier IDID TypeIssuer
ID806388100Medicaid
ID808328200Medicaid
ID808367901Medicaid
ID808280600Medicaid
ID808367900Medicaid
ID808328100Medicaid