Provider Demographics
NPI:1760823033
Name:ACI SUPPORT SPECIALISTS, INC
Entity Type:Organization
Organization Name:ACI SUPPORT SPECIALISTS, INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:DIRECTOR OF FINANCE
Authorized Official - Prefix:MR
Authorized Official - First Name:MITESH
Authorized Official - Middle Name:
Authorized Official - Last Name:PATEL
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:919-861-2000
Mailing Address - Street 1:8504 SIX FORKS RD
Mailing Address - Street 2:SUITE 101
Mailing Address - City:RALEIGH
Mailing Address - State:NC
Mailing Address - Zip Code:27615-3261
Mailing Address - Country:US
Mailing Address - Phone:919-861-2000
Mailing Address - Fax:919-861-2001
Practice Address - Street 1:5213 PRONGHORN LN
Practice Address - Street 2:
Practice Address - City:RALEIGH
Practice Address - State:NC
Practice Address - Zip Code:27610-6512
Practice Address - Country:US
Practice Address - Phone:919-861-2000
Practice Address - Fax:919-861-2001
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2013-07-15
Last Update Date:2013-07-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251C00000XAgenciesDay Training, Developmentally Disabled Services
Provider Identifiers
StateIdentifier IDID TypeIssuer
NC3408221Medicaid