Provider Demographics
NPI:1992201156
Name:A & C SUPPORT SERVICES INC.
Entity Type:Organization
Organization Name:A & C SUPPORT SERVICES INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CEO
Authorized Official - Prefix:MS
Authorized Official - First Name:EBONY
Authorized Official - Middle Name:
Authorized Official - Last Name:HOUZE
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:703-659-8404
Mailing Address - Street 1:1602 BELLE VIEW BLVD # 3015
Mailing Address - Street 2:
Mailing Address - City:ALEXANDRIA
Mailing Address - State:VA
Mailing Address - Zip Code:22307-6531
Mailing Address - Country:US
Mailing Address - Phone:540-307-1054
Mailing Address - Fax:
Practice Address - Street 1:1602 BELLE VIEW BLVD # 3015
Practice Address - Street 2:
Practice Address - City:ALEXANDRIA
Practice Address - State:VA
Practice Address - Zip Code:22307-6531
Practice Address - Country:US
Practice Address - Phone:703-659-8404
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2018-04-04
Last Update Date:2020-12-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251B00000XAgenciesCase Management
No251S00000XAgenciesCommunity/Behavioral Health
No251X00000XAgenciesSupports Brokerage
No252Y00000XAgenciesEarly Intervention Provider Agency
No253Z00000XAgenciesIn Home Supportive Care
No302F00000XManaged Care OrganizationsExclusive Provider Organization