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DOMINIQUE L GIST NPI 1629674742


NPI Information

NPI: 1629674742
Provider Name: DOMINIQUE L GIST
Classification: Psychiatric Residential Treatment Facility - 323P00000X
Entity Type: Individual
Address:
8674 S 165TH AVE
GOODYEAR, AZ
ZIP 85338
Phone: (313) 434-6821
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Dominique L Gist is a psychiatric residential treatment facility in Goodyear, AZ. The provider is 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 Dominique L Gist NPI is 1629674742. The provider is registered as an individual entity type.

The NPPES NPI record indicates the provider is a female.

The provider's business location address is:

8674 S 165TH AVE
GOODYEAR, AZ
ZIP 85338-447
Phone: (313) 434-6821

The enumeration date for this NPI number is 12/5/2020 and was last updated on 12/5/2020.


Taxonomy Codes

The NPI record includes the healthcare provider taxonomy classification, state license number and state of licensure. The following information regarding the scope of practice of this provider is available:

No.Taxonomy CodeTaxonomy ClasificationTaxonomy SpecializationLicense NumberLicense StatePrimary
1320800000XCommunity Based Residential Treatment Facility, Mental IllnessNo
2251S00000XCommunity/Behavioral HealthNo
3324500000XSubstance Abuse Rehabilitation FacilityNo
4332800000XIndian Health Service/Tribal/Urban Indian Health (I/T/U) PharmacyNo
5323P00000XPsychiatric Residential Treatment FacilityYes

What is NPI?

NPI stands for National Provider Identifier. The NPI is a 10-digit identification number that is completely unique. The NPI number by itself does not contain any identifiable information such as a provider’s speciality or location. The NPI is assigned to individuals or organizacions for their lifespan and it is independent of key provider information type updates like a change of practices, location or speciality.

This page was last updated on: 11/14/2023

All materials and services on this site are provided on an "as is" and "as available" basis without warranty of any kind. The NPI record is maintained by the National Plan & Provider Enumeration System (NPPES) and anyone may request this information and other NPPES health care provider data from HHS under The Freedom of Information Act (FOIA), Title 5 of the United States Code, section 552. To update the NPI records please contact the NPPES.