NPIMap

Organization Active NPI

A.C.E. Community Support Services, LLC

  • Community/Behavioral Health Agency
  • Marietta, GA
National Provider Identifier
1811269723
Registry record updated Sep 14, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Community/Behavioral Health AgencyTaxonomy code 251S00000X
Legal business name
A.C.E. COMMUNITY SUPPORT SERVICES, LLC
Practice address
1238 Powers Ferry CMN SE
Marietta, GA 30067-6046
Phone
(678) 401-4596
Fax
(678) 401-3126
NPI assigned
Feb 8, 2012
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Sep 14, 2021

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name
Mr. Kalique N Woodbury
Title
Ceo/Executive Director
Phone
(678) 401-4596

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Community/Behavioral Health Agency 251S00000X GA Primary

Addresses

Primary practice location

1238 Powers Ferry CMN SE
Marietta, GA 30067-6046

Mailing address

1238 Powers Ferry CMN SE
Marietta, GA 30067-6046
Phone (678) 401-4596

Other identifiers 3

IdentifierTypeStateIssuer
314877275CMedicaidGA
341877275BMedicaidGA
341877275AMedicaidGA

Other names 1

  • ACE Community Support Services, LLC Other name

National Provider Directory

National Provider Directory
Tax ID family
Ace Community Support Services LLC2 organizations share this tax ID, including this one

Other organizations with this tax ID 1

Organizations that report the same tax identification number in the National Provider Directory.

Locations

1238 Powers Ferry Cmn SE
Marietta, GA 30067
Phone (678) 401-4596

2759 Delk Rd SE
Ste 1200
Marietta, GA 30067
Phone (678) 401-4596

Practitioners & affiliated clinicians

Practitioners 5

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1328659200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1631577600000",
    "number": "1811269723",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1238 POWERS FERRY CMN SE",
            "city": "MARIETTA",
            "state": "GA",
            "postal_code": "300676046",
            "telephone_number": "678-401-4596",
            "fax_number": "678-401-3126"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1238 POWERS FERRY CMN SE",
            "city": "MARIETTA",
            "state": "GA",
            "postal_code": "300676046",
            "telephone_number": "678-401-4596",
            "fax_number": "678-401-3126"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "A.C.E. COMMUNITY SUPPORT SERVICES, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2012-02-08",
        "last_updated": "2021-09-14",
        "certification_date": "2021-09-14",
        "status": "A",
        "authorized_official_last_name": "WOODBURY",
        "authorized_official_first_name": "KALIQUE",
        "authorized_official_middle_name": "N",
        "authorized_official_title_or_position": "CEO/EXECUTIVE DIRECTOR",
        "authorized_official_telephone_number": "678-401-4596",
        "authorized_official_name_prefix": "Mr."
    },
    "taxonomies": [
        {
            "code": "251S00000X",
            "taxonomy_group": "",
            "desc": "Community/Behavioral Health",
            "state": "GA",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "314877275C",
            "state": "GA"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "341877275B",
            "state": "GA"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "341877275A",
            "state": "GA"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "ACE Community Support Services, LLC",
            "code": "5",
            "type": "Other Name"
        },
        {
            "organization_name": "ACE Community Support Services, LLC",
            "code": "5",
            "type": "Other Name"
        }
    ]
}

Other providers in Marietta, GA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 14, 2021; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.