Healthcare Provider Details

I. General information

NPI: 1609719244
Provider Name (Legal Business Name): ACTION FOR COMMUNITY TREATMENT SERVICES ,LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 04/09/2026
Last Update Date: 04/09/2026
Certification Date: 04/09/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

7460 E HACKAMORE LN
SAN TAN VALLEY AZ
85143-0190
US

IV. Provider business mailing address

7460 E HACKAMORE LN
SAN TAN VALLEY AZ
85143-0190
US

V. Phone/Fax

Practice location:
  • Phone: 267-777-0456
  • Fax:
Mailing address:
  • Phone: 267-777-0456
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code101YA0400X
TaxonomyAddiction (Substance Use Disorder) Counselor
License Number
License Number State
# 2
Primary TaxonomyY
Taxonomy Code101YM0800X
TaxonomyMental Health Counselor
License Number
License Number State

VIII. Authorized Official

Name: DIANA N KIBUUKA
Title or Position: OWNER
Credential:
Phone: 267-777-0457