03D2119924 CLIA NUMBER - PAYSON OUTPATIENT SERVICE CENTER - 2

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Laboratory Demographics

CLIA Number: 03D2119924

Facility Name: PAYSON OUTPATIENT SERVICE CENTER - 2

Facility Address:
803 W MAIN STREET
PAYSON, AZ
ZIP 85541
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Facility Phone Number: 480 831-7566

Facility Type: Other - MENTAL HEALTH FACILITY

Certificate Type: Waiver

NPI Number: 1548416514

Taxonomy: 251S00000X - Community/Behavioral Health
A private or public agency usually under local government jurisdiction, responsible for assuring the delivery of community based mental health, intellectual disabilities, substance abuse and/or behavioral health services to individuals with those disabilities. Services may range from companion care, respite, transportation, community integration, crisis intervention and stabilization, supported employment, day support, prevocational services, residential support, therapeutic and supportive consultation, environmental modifications, intensive in-home therapy and day treatment, in addition to traditional mental health and behavioral treatment.

CLIA Record

Field Name	Field Value
CLIA Number	03D2119924
LAB Type	Other - MENTAL HEALTH FACILITY
Facility Name	PAYSON OUTPATIENT SERVICE CENTER - 2
Street	803 W MAIN STREET
City	PAYSON
State	AZ
ZIP	85541
Phone	480 831-7566
CertificateType	4
CertificateEffectiveDate	10/6/2022
CertificateExpirationDate	10/5/2024
FacilityType	Waiver

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This page was last updated on: 4/23/2024