Provider Demographics
NPI:1295038529
Name:ARIZONA COUNSELING & TREATMENT SERVICES, L.L.C.
Entity Type:Organization
Organization Name:ARIZONA COUNSELING & TREATMENT SERVICES, L.L.C.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CHIEF OPERATING OFFICER
Authorized Official - Prefix:MR
Authorized Official - First Name:ROBERT
Authorized Official - Middle Name:
Authorized Official - Last Name:LIBBERTON
Authorized Official - Suffix:
Authorized Official - Credentials:MBA
Authorized Official - Phone:928-376-0220
Mailing Address - Street 1:2573 S ARIZONA AVE
Mailing Address - Street 2:STE. D
Mailing Address - City:YUMA
Mailing Address - State:AZ
Mailing Address - Zip Code:85364-7336
Mailing Address - Country:US
Mailing Address - Phone:928-376-0220
Mailing Address - Fax:928-376-0709
Practice Address - Street 1:#24 HOWELL ST.
Practice Address - Street 2:
Practice Address - City:BISBEE
Practice Address - State:AZ
Practice Address - Zip Code:85603
Practice Address - Country:US
Practice Address - Phone:928-376-0220
Practice Address - Fax:928-376-0709
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:ARIZONA COUNSELING & TREATMENT SERVICES
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2010-12-08
Last Update Date:2010-12-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AZBH 3777251S00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251S00000XAgenciesCommunity/Behavioral Health