AGENCY FOR COMMUNITY TREATMENT SERVICES, INC. (NPI# 1104894914) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1104894914 |
| Entity Type | Organization |
| Organization Name | AGENCY FOR COMMUNITY TREATMENT SERVICES, INC. |
| Practice Address |
4612 N 56th St Tampa FL 33610-7123 |
| Practice Telephone | 8132464899 |
| Practice Fax Number | 8136216899 |
| Mailing Telephone | 8132464899 |
| Mailing Fax Number | 8136216899 |
| Enumeration Date | 2006-03-08 |
| Last Update Date | 2015-04-13 |
| Authorized Official Name | RICHARD E BROWN (CHIEF EXECUTIVE OFFICER) |
| Authorized Official Telephone | 8132464899 |
| Authorized Official Credential | MSW |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| N | 251V00000X | Voluntary or Charitable | Agencies | ||
| Y | 261QM0801X |
Clinic/Center Specialization: Mental Health (Including Community Mental Health Center) |
Ambulatory Health Care Facilities |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| FL | 060556505 | 05 | |
| FL | 060556509 | 05 | |
| FL | 060556500 | 05 |
| Street Address |
4612 N 56TH ST |
| City | TAMPA |
| State | FL |
| Zip Code | 33610-7123 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1487296711 | Barbara Secor | Counselor | 4612 N 56th St, Tampa, FL 33610-7123 | 2019-10-08 |
| 1750922084 | Miscaline Presume | Counselor | 4612 N 56th St, Tampa, FL 33610-7123 | 2019-10-08 |
| 1649747635 | Jennifer Botsch | Counselor | 4612 N 56th St, Tampa, FL 33610-7123 | 2018-10-27 |
| 1821460197 | Floret Jamie Lee Miller | Counselor | 4612 N 56th St, Tampa, FL 33610-7123 | 2015-10-27 |
| 1902273600 | Mason Sikes Jr. | Counselor | 4612 N 56th St, Tampa, FL 33610-7123 | 2015-08-28 |
| 1508273681 | Pamela Milbry | Counselor | 4612 N 56th St, Tampa, FL 33610-7123 | 2014-07-21 |
| 1487904421 | Acts | Community/Behavioral Health | 4612 N 56th St, Tampa, FL 33610-7123 | 2012-09-18 |
| 1013210509 | Patricia Horton | Counselor | 4612 N 56th St, Tampa, FL 33610-7123 | 2010-12-06 |
| 1215245071 | Sondra Mullins | Counselor | 4612 N 56th St, Tampa, FL 33610-7123 | 2010-09-15 |
| 1598070187 | Cynthia A Westfield | Counselor | 4612 N 56th St, Tampa, FL 33610-7123 | 2010-08-09 |
| Find all providers in the same location | ||||
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1184273161 | Mayra Iris Pesante Lopez | Behavior Technician | 10150 Highlands Manor Drive Suite 200, Tampa, FL 33610 | 2019-09-11 |
| 1902464381 | Ruth Hosen Milfort | Case Manager/Care Coordinator | 5707 N. 22nd Street, Tampa, FL 33610 | 2019-05-31 |
| 1265914626 | Universal Transportation Management Inc | Non-emergency Medical Transport (VAN) | 4108 N 22nd Street, Tampa, FL 33610 | 2018-09-02 |
| 1346759115 | Speedway Plus 2 Car Care Center LLCc | Residential Treatment Facility, Physical Disabilities | 8007 Glenoak Rd., Tampa, FL 33610 | 2017-09-25 |
| 1245757707 | Duy Dang | Behavioral Analyst | 4402 Claymore Dr Unit 203, Tampa, FL 33610 | 2017-08-25 |
| 1144745043 | Jonequa Baker | Home Health Aide | 709 North Castle Court, Tampa, FL 33610 | 2017-08-11 |
| 1619401338 | Dedicated Senior Medical Center East Tampa, LLC. | Non-Pharmacy Dispensing Site | 3128 East Hillsborough Avenue, Dedicated Senior Medical Center East Tampa, LLC., Tampa, FL 33610 | 2017-04-19 |
| 1669917423 | Olivia Anderson | Counselor | 10150 Highland Manor Dr Ste 200#108, Tampa, FL 33610 | 2017-01-03 |
| 1952779050 | Tampa Family Health Centers, Inc | Clinic/Center | 3100 E. Fletcher Avenue, Tampa, FL 33610 | 2015-09-04 |
| 1215303821 | Morissa Kidd | Technician, Other | 8062 Deerwood Circle, Tampa, FL 33610 | 2015-08-18 |
| Find all providers in zip 33610 | ||||
| Taxonomy Code | 261QM0801X |
| Grouping | Ambulatory Health Care Facilities |
| Classification | Clinic/Center |
| Specialization | Mental Health (Including Community Mental Health Center) |
| Definition to come... |
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| 1336775733 | Life Balance Medical Group LLC | Clinic/Center | 4102 W Linebaugh Ave Ste 101, Tampa, FL 33624-5296 | 2020-03-17 |
| 1104457977 | Lara Health and Wellness Center LLC | Clinic/Center | 3105 W Waters Ave Ste 105, Tampa, FL 33614-2846 | 2020-01-30 |
| 1588204192 | Natalie Rosado | Clinic/Center | 7302 Sheldon Rd, Tampa, FL 33615-2327 | 2020-01-11 |
| 1003477662 | Embracing Changes Center for Wellness | Clinic/Center | 2203 N Lois Ave Ste 903, Tampa, FL 33607-2306 | 2019-06-25 |
| 1508324781 | Breakthrough Counseling Services, LLC | Clinic/Center | 3105 W Azeele St, Tampa, FL 33609-3089 | 2019-03-07 |
| 1013405281 | Crudup Psychological Services LLC | Clinic/Center | 10001 Cross Creek Blvd, Tampa, FL 33647-2581 | 2018-04-24 |
| 1346753134 | Mental Fitness Group, LLC | Clinic/Center | 8875 Hidden River Pkwy Ste 300, Tampa, FL 33637 | 2017-11-15 |
| Find all providers in TAMPA | ||||
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| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.