Provider Demographics
NPI:1508451873
Name:ACE BEHAVIORAL CONSULTING LLC
Entity Type:Organization
Organization Name:ACE BEHAVIORAL CONSULTING LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CLINICAL DIRECTOR
Authorized Official - Prefix:
Authorized Official - First Name:AMIE
Authorized Official - Middle Name:
Authorized Official - Last Name:MERRELL
Authorized Official - Suffix:
Authorized Official - Credentials:LBA, BCBA
Authorized Official - Phone:801-634-8172
Mailing Address - Street 1:9971 S BORG DR
Mailing Address - Street 2:
Mailing Address - City:SANDY
Mailing Address - State:UT
Mailing Address - Zip Code:84092-4117
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:9971 S BORG DR
Practice Address - Street 2:
Practice Address - City:SANDY
Practice Address - State:UT
Practice Address - Zip Code:84092-4117
Practice Address - Country:US
Practice Address - Phone:801-634-8172
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2021-03-08
Last Update Date:2021-03-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes103K00000XBehavioral Health & Social Service ProvidersBehavior AnalystGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
0OtherNONE