Provider Demographics
NPI:1710675848
Name:ACE BEHAVIORAL HEALTH & WELLNESS
Entity Type:Organization
Organization Name:ACE BEHAVIORAL HEALTH & WELLNESS
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:MORNA
Authorized Official - Middle Name:M
Authorized Official - Last Name:AGOKI
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:360-207-2344
Mailing Address - Street 1:2620 SHADY GROVE LN
Mailing Address - Street 2:
Mailing Address - City:MCKINNEY
Mailing Address - State:TX
Mailing Address - Zip Code:75071-2715
Mailing Address - Country:US
Mailing Address - Phone:360-207-2344
Mailing Address - Fax:360-323-4131
Practice Address - Street 1:1400 112TH AVE SE STE 100
Practice Address - Street 2:
Practice Address - City:BELLEVUE
Practice Address - State:WA
Practice Address - Zip Code:98004-6901
Practice Address - Country:US
Practice Address - Phone:360-207-2344
Practice Address - Fax:360-323-4131
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2023-04-26
Last Update Date:2024-01-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes363LP0808XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerPsychiatric/Mental HealthGroup - Multi-Specialty