Provider Demographics
NPI:1891530150
Name:ACE COMPREHENSIVE HEATH AND WELLNESS
Entity type:Organization
Organization Name:ACE COMPREHENSIVE HEATH AND WELLNESS
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:APRN- BC, PMHNP- BC
Authorized Official - Prefix:
Authorized Official - First Name:SHAUNETTE
Authorized Official - Middle Name:
Authorized Official - Last Name:PHILLIPS
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:561-389-3808
Mailing Address - Street 1:8937 GULF RUN WAY
Mailing Address - Street 2:
Mailing Address - City:LAKE WORTH
Mailing Address - State:FL
Mailing Address - Zip Code:33467-1105
Mailing Address - Country:US
Mailing Address - Phone:561-389-3808
Mailing Address - Fax:
Practice Address - Street 1:8937 GULF RUN WAY
Practice Address - Street 2:
Practice Address - City:LAKE WORTH
Practice Address - State:FL
Practice Address - Zip Code:33467-1105
Practice Address - Country:US
Practice Address - Phone:561-389-3808
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2024-06-28
Last Update Date:2024-06-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes363LP0808XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerPsychiatric/Mental HealthGroup - Single Specialty
No251S00000XAgenciesCommunity/Behavioral Health