Provider Demographics
NPI:1801226303
Name:ARIZONA COUNSELING & TREATMENT SERVCIES
Entity Type:Organization
Organization Name:ARIZONA COUNSELING & TREATMENT SERVCIES
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:ADMINISTRATIVE SPECIALIST
Authorized Official - Prefix:
Authorized Official - First Name:MATTHEW
Authorized Official - Middle Name:AARON
Authorized Official - Last Name:BURGESS
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:928-919-2373
Mailing Address - Street 1:1590 S 2ND AVE
Mailing Address - Street 2:
Mailing Address - City:YUMA
Mailing Address - State:AZ
Mailing Address - Zip Code:85364-4728
Mailing Address - Country:US
Mailing Address - Phone:928-376-0220
Mailing Address - Fax:928-376-0709
Practice Address - Street 1:114 & 116 S ARIZONA AVENUE
Practice Address - Street 2:
Practice Address - City:WILLCOX
Practice Address - State:AZ
Practice Address - Zip Code:85644
Practice Address - Country:US
Practice Address - Phone:928-376-0220
Practice Address - Fax:520-384-6155
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:ARIZONA COUNSELING & TREATMENT SERVCIES
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2013-11-19
Last Update Date:2013-11-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AZBH4399251S00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251S00000XAgenciesCommunity/Behavioral Health