Organization Name: | ACE PSYCHOLOGICAL SERVICES LLC |
NPI Number: | 1033515333 |
Entity Type Code: | Organizational (2) |
Authorized Official Name: | AMYNDA RHODES (SOLE MEMBER) |
Mailing Address: | 30 Custer Rd Heath |
State: | OH US |
Postal Code: | 430561312 |
Phone Number: | 7408773440 |
Fax Number: | |
NPI Enumeration Date: | 11/13/2014 |
NPI Last Update Date: | 11/13/2014 |
Replacement NPI: | 0 |
NPI Deactivation Date: | |
NPI Reactivation Date: |
Taxonomy Information: | |
Healthcare Provider Taxonomy: | 103TA0400X |
License Number: | 6873 |
Healthcare Provider Taxonomy: (Secondary) | Y |
State: | OH |
Taxonomy Type: | Behavioral Health & Social Service Providers |
Taxonomy Classification: | Psychologist |
Taxonomy Specialization: | Addiction (Substance Use Disorder) |
Taxonomy Definition: |