Provider Demographics
NPI:1891251740
Name:ACEMARK BEHAVIOR SERVICES LLC
Entity Type:Organization
Organization Name:ACEMARK BEHAVIOR SERVICES LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:ACE
Authorized Official - Middle Name:ROBERT
Authorized Official - Last Name:JONES
Authorized Official - Suffix:II
Authorized Official - Credentials:
Authorized Official - Phone:606-416-6112
Mailing Address - Street 1:58 PUBLIC SQ STE B
Mailing Address - Street 2:
Mailing Address - City:SOMERSET
Mailing Address - State:KY
Mailing Address - Zip Code:42501-1487
Mailing Address - Country:US
Mailing Address - Phone:606-416-6112
Mailing Address - Fax:
Practice Address - Street 1:58 PUBLIC SQ STE B
Practice Address - Street 2:
Practice Address - City:SOMERSET
Practice Address - State:KY
Practice Address - Zip Code:42501-1487
Practice Address - Country:US
Practice Address - Phone:606-416-6112
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2019-02-15
Last Update Date:2019-02-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251S00000XAgenciesCommunity/Behavioral Health