Provider Demographics
NPI:1104894914
Name:AGENCY FOR COMMUNITY TREATMENT SERVICES, INC.
Entity type:Organization
Organization Name:AGENCY FOR COMMUNITY TREATMENT SERVICES, INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CEO
Authorized Official - Prefix:
Authorized Official - First Name:ASHA
Authorized Official - Middle Name:
Authorized Official - Last Name:PEREYRA
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:813-246-4899
Mailing Address - Street 1:3450 BUSCHWOOD PARK DR STE 345
Mailing Address - Street 2:
Mailing Address - City:TAMPA
Mailing Address - State:FL
Mailing Address - Zip Code:33618-4447
Mailing Address - Country:US
Mailing Address - Phone:813-246-4899
Mailing Address - Fax:813-621-6899
Practice Address - Street 1:8605 N BRANCH AVE
Practice Address - Street 2:
Practice Address - City:TAMPA
Practice Address - State:FL
Practice Address - Zip Code:33604-1404
Practice Address - Country:US
Practice Address - Phone:813-246-4899
Practice Address - Fax:813-621-6899
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-03-08
Last Update Date:2025-03-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251S00000XAgenciesCommunity/Behavioral Health
No324500000XResidential Treatment FacilitiesSubstance Abuse Rehabilitation Facility
No3245S0500XResidential Treatment FacilitiesSubstance Abuse Rehabilitation FacilitySubstance Abuse Treatment, Children
No251V00000XAgenciesVoluntary or Charitable
No261QM0801XAmbulatory Health Care FacilitiesClinic/CenterMental Health (Including Community Mental Health Center)
Provider Identifiers
StateIdentifier IDID TypeIssuer
FL060556500Medicaid
FL060556505Medicaid
FL060556509Medicaid