1891743423 NPI number — AGENCY FOR COMMUNITY TREATMENT SERVICES INC

Table of content: (NPI 1891743423)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1891743423 NPI number — AGENCY FOR COMMUNITY TREATMENT SERVICES INC

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
AGENCY FOR COMMUNITY TREATMENT SERVICES INC
Provider Last Name:
Provider First Name:
Provider Middle Name:
Provider Name Prefix Text:
Provider Name Suffix Text:
Provider Credential Text:
Provider Gender Code:

Provider's Other Name Information

Provider Other Organization Name:
Provider Other Organization Name Type Code:
Provider Other Last Name:
Provider Other First Name:
Provider Other Middle Name:
Provider Other Name Prefix Text:
Provider Other Name Suffix Text:
Provider Other Credential Text:
Provider Other Last Name Type Code:

NPI Number Information

NPI Number:
1891743423
Entity Type Code:
Organization
Replacement NPI:
Last Update Date:
10/19/2022
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
4612 N 56TH ST
Provider Second Line Business Mailing Address:
Provider Business Mailing Address City Name:
TAMPA
Provider Business Mailing Address State Name:
FL
Provider Business Mailing Address Postal Code:
33610-7123
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
813-246-4899
Provider Business Mailing Address Fax Number:
813-621-6899

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
4612 N 56TH ST
Provider Second Line Business Practice Location Address:
Provider Business Practice Location Address City Name:
TAMPA
Provider Business Practice Location Address State Name:
FL
Provider Business Practice Location Address Postal Code:
33610-7123
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
813-246-4899
Provider Business Practice Location Address Fax Number:
813-621-6899
Provider Enumeration Date:
05/05/2006

Additional Information

Authorized Official

Authorized Official Last Name:
PEREYRA
Authorized Official First Name:
ASHA
Authorized Official Middle Name:
Authorized Official Title or Position:
CEP
Authorized Official Telephone Number:
813-246-4899

Provider Taxonomy Codes

  • Taxonomy code: 251V00000X , with the licence number:  SR29AD062602 , registered in the state of FL ; information, associated with the NPI states the following Primary Taxonomy Switch: "N" .
  • Taxonomy code: 251V00000X , with the licence number: SR29AD062601 , registered in the state of FL ; information, associated with the NPI states the following Primary Taxonomy Switch: "N" .
  • Taxonomy code: 251V00000X , with the licence number: SR29AD062603 , registered in the state of FL ; information, associated with the NPI states the following Primary Taxonomy Switch: "N" .
  • Taxonomy code: 251V00000X , with the licence number: SR29AD062606 , registered in the state of FL ; information, associated with the NPI states the following Primary Taxonomy Switch: "N" .
  • Taxonomy code: 251V00000X , with the licence number: SR29AD062609 , registered in the state of FL ; information, associated with the NPI states the following Primary Taxonomy Switch: "N" .
  • Taxonomy code: 251V00000X , with the licence number: SR29AD062604 , registered in the state of FL ; information, associated with the NPI states the following Primary Taxonomy Switch: "N" .
  • Taxonomy code: 251V00000X , with the licence number: SR29AD062608 , registered in the state of FL ; information, associated with the NPI states the following Primary Taxonomy Switch: "N" .
  • Taxonomy code: 251V00000X , with the licence number: SR29AD062610 , registered in the state of FL ; information, associated with the NPI states the following Primary Taxonomy Switch: "N" .
  • Taxonomy code: 251V00000X , with the licence number: SR29AD062611 , registered in the state of FL ; information, associated with the NPI states the following Primary Taxonomy Switch: "N" .
  • Taxonomy code: 251V00000X , with the licence number: SR29AD062612 , registered in the state of FL ; information, associated with the NPI states the following Primary Taxonomy Switch: "N" .
  • Taxonomy code: 251V00000X , with the licence number: SR29AD062613 , registered in the state of FL ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

Other Provider's Identifiers (legacy, non-NPI)

  • Identifier: 060556510 , issued by the state of ( FL ) . This identifiers is of the category "MEDICAID".
  • Identifier: 060556505 , issued by the state of ( FL ) . This identifiers is of the category "MEDICAID".
  • Identifier: 060556511 , issued by the state of ( FL ) . This identifiers is of the category "MEDICAID".
  • Identifier: 060556503 , issued by the state of ( FL ) . This identifiers is of the category "MEDICAID".
  • Identifier: 060556509 , issued by the state of ( FL ) . This identifiers is of the category "MEDICAID".
  • Identifier: 060556500 , issued by the state of ( FL ) . This identifiers is of the category "MEDICAID".
  • Identifier: 060556508 , issued by the state of ( FL ) . This identifiers is of the category "MEDICAID".




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