Organization
A.C.E. COMMUNITY SUPPORT SERVICES, LLC
Active
Other names
ACE Community Support Services, LLC
Organization subpart
No
Provider details
NPI number
Authorized official
MR. KALIQUE N WOODBURY (CEO/EXECUTIVE DIRECTOR)
(678) 401-4596
Entity
Organization
Contact information
Practice address
1238 POWERS FERRY CMN SE, MARIETTA, GA 30067-6046
(678) 401-4596
(678) 401-3126
Mailing address
1238 POWERS FERRY CMN SE, MARIETTA, GA 30067-6046
(678) 401-4596
(678) 401-3126
Taxonomy
Speciality
Code
Description
License number
State
251S00000X
Community/Behavioral Health Agency
Primary
—
GA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
314877275C
—
GA
05
—
341877275A
—
GA
05
—
341877275B
—
GA
Enumeration date
02/08/2012
Last updated
09/14/2021
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