Provider Demographics
NPI:1558686048
Name:ACE PRIVATE CARE,LLC
Entity Type:Organization
Organization Name:ACE PRIVATE CARE,LLC
Other - Org Name:QUALITY LIVING PRIVATE DUTY
Other - Org Type:Doing Business As
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:MR
Authorized Official - First Name:BASIL
Authorized Official - Middle Name:
Authorized Official - Last Name:BACALL
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:517-719-5178
Mailing Address - Street 1:15565 NORTHLAND DR.
Mailing Address - Street 2:SUITE 704 W
Mailing Address - City:SOUTHFIELD
Mailing Address - State:MI
Mailing Address - Zip Code:48075
Mailing Address - Country:US
Mailing Address - Phone:248-996-8107
Mailing Address - Fax:248-423-1722
Practice Address - Street 1:15565 NORTHLAND DR.
Practice Address - Street 2:SUITE 704 W
Practice Address - City:SOUTHFIELD
Practice Address - State:MI
Practice Address - Zip Code:48075
Practice Address - Country:US
Practice Address - Phone:248-996-8107
Practice Address - Fax:248-423-1722
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:ACE PRIVATE CARE, LLC
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2010-03-29
Last Update Date:2010-03-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MI251E00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251E00000XAgenciesHome Health