Individual provider · Type 1 NPI
Dominique L. Gist
Psychiatric Residential Treatment Facility · Goodyear, AZ
Practice location
8674 S 165th Ave
Goodyear, AZ 85338-1447
Mailing address
11213 W Ivory Ln
Avondale, AZ 85392-3916
Specialties and licenses
| Taxonomy | Code | License |
|---|---|---|
| Mental Illness Community Based Residential Treatment Facility | 320800000X | None listed |
| Community/Behavioral Health Agency | 251S00000X | None listed |
| Substance Abuse Rehabilitation Facility | 324500000X | None listed |
| Indian Health Service/Tribal/Urban Indian Health (I/T/U) Pharmacy | 332800000X | None listed |
| Psychiatric Residential Treatment Facility Primary | 323P00000X | None listed |
Psychiatric Residential Treatment Facility: A residential treatment facility (RTF) is a facility or distinct part of a facility that provides to children and adolescents, a total, twenty-four hour, therapeutically planned group living and learning situation where distinct and individualized psychotherapeutic interventions can take place. Residential treatment is a specific level of care to be differentiated from acute, intermediate, and long-term hospital car…
Another provider at this address
About NPI 1629674742
Dominique L. Gist's National Provider Identifier is 1629674742, issued on Dec 5, 2020. The primary taxonomy on file is Psychiatric Residential Treatment Facility (323P00000X), and the practice location is in Goodyear, AZ. The record was last updated on Dec 5, 2020.