03D2105177 CLIA NUMBER - ANASAZI FOUNDATION

Laboratory Demographics

CLIA Number: 03D2105177

Facility Name: ANASAZI FOUNDATION

Facility Address:
1424 S STAPLEY DR
MESA, AZ
ZIP 85204
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Facility Phone Number: (408) 892-7403

Facility Type: OTHER

Certificate Type: Waiver

NPI Number: 1497833644

Taxonomy: 323P00000X - 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 care, when the least restrictive environment is maintained to allow for normalization of the patient's surroundings. The RTF must be both physically and programmatically distinct if it is a part or subunit of a larger treatment program. An RTF is organized and professionally staffed to provide residential treatment of mental disorders to children and adolescents who have sufficient intellectual potential to respond to active treatment (that is, for whom it can reasonably be assumed that treatment of the mental disorder will result in an improved ability to function outside the RTF) for whom outpatient treatment, partial hospitalization or protected and structured environment is medically or psychologically necessary

CLIA Record

Field Name	Field Value
CLIA Number	03D2105177
LAB Type	OTHER
Facility Name	ANASAZI FOUNDATION
Street	1424 S STAPLEY DR
City	MESA
State	AZ
ZIP	85204
Phone	(408) 892-7403

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This page was last updated on: 5/11/2023