Provider Demographics
NPI:1770817967
Name:ALTERNATIVE COMMUNITY ENRICHMENT SERVICES, INC.
Entity Type:Organization
Organization Name:ALTERNATIVE COMMUNITY ENRICHMENT SERVICES, INC.
Other - Org Name:ACES COMMUNITY SERVICES
Other - Org Type:Doing Business As
Authorized Official - Title/Position:OPERATIONS MANAGER
Authorized Official - Prefix:
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 STREET
Mailing Address - Street 2:
Mailing Address - City:COEUR D ALENE
Mailing Address - State:ID
Mailing Address - Zip Code:83814
Mailing Address - Country:US
Mailing Address - Phone:208-292-2188
Mailing Address - Fax:208-292-2189
Practice Address - Street 1:609 BANK STREET
Practice Address - Street 2:
Practice Address - City:WALLACE
Practice Address - State:ID
Practice Address - Zip Code:83873
Practice Address - Country:US
Practice Address - Phone:208-556-0960
Practice Address - Fax:208-752-1048
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:ALTERNATIVE COMMUNITY ENRICHMENT SERVICES, INC.
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2009-09-22
Last Update Date:2011-03-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
ID104100000X
ID251S00000X251S00000X
ID251E00000X251S00000X
251S00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes104100000XBehavioral Health & Social Service ProvidersSocial WorkerGroup - Multi-Specialty
No251S00000XAgenciesCommunity/Behavioral Health
Provider Identifiers
StateIdentifier IDID TypeIssuer
ID1912127648Medicaid
ID1295956266Medicaid
ID1548414519Medicaid
ID1093935728Medicaid
ID1215055868Medicaid
ID1174767180Medicaid
ID1689689085Medicaid