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Dominique L Gist
Psychiatric Residential Treatment Facility in Goodyear, Arizona
NPI 1629674742

Dominique L Gist is a Psychiatric Residential Treatment Facility based in Avondale, AZ. Dominique L Gist practices in Goodyear, AZ. The NPI Number for Dominique L Gist is 1629674742 and holds a License No. (Arizona).

The current practice location address for Dominique L Gist is 8674 S 165Th Ave, Goodyear, AZ and can be reached out via phone at 313-434-6821. You can also correspond with Dominique L Gist through the mailing address at 11213 W IVORY LN, AVONDALE, AZ - 85392-3916 (mailing address contact number: 313-434-6821).

Location: 8674 S 165Th Ave, Goodyear, AZ, 85392-3916
Profile Details Legacy Identifiers Practice Address Mailing Address Primary Taxonomy
person
Provider Profile Details
NPI Number
1629674742
Provider Name
Dominique L Gist
Credential
Provider Entity Type
Individual
Gender
Female
Address
8674 S 165Th Ave, Goodyear, AZ, 85392-3916
Phone Number
313-434-6821
Fax Number
Provider Enumeration Date
12/05/2020
Last Update Date
03/10/2024
institution
Provider Business Practice Location Address Details
Address
8674 S 165Th Ave
City
Goodyear
State
Arizona
Zip
85338-1447
Phone Number
313-434-6821
Fax Number
person
Provider Business Mailing Address Details
Address
8674 S 165Th Ave
City
Goodyear
State
Arizona
Zip
85338-1447
Phone Number
313-434-6821
Fax Number
person
Provider's Taxonomy Details 1
Type
Agencies
Classification
Community/Behavioral Health
Speciality
-
Taxonomy
251S00000X
License No.
()
Definition
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.
person
Provider's Taxonomy Details 2
Type
Residential Treatment Facilities
Classification
Community Based Residential Treatment Facility, Mental Illness
Speciality
-
Taxonomy
320800000X
License No.
()
Definition
A home-like residential facility providing psychiatric treatment and psycho/social rehabilitative services to individuals diagnosed with mental illness.
person
Provider's Taxonomy Details 3
Type
Residential Treatment Facilities
Classification
Psychiatric Residential Treatment Facility
Speciality
-
Taxonomy
323P00000X
License No.
()
Definition
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
person
Provider's Taxonomy Details 4
Type
Residential Treatment Facilities
Classification
Substance Abuse Rehabilitation Facility
Speciality
-
Taxonomy
324500000X
License No.
()
Definition
A facility or distinct part of a facility that provides a 24 hr therapeutically planned living and rehabilitative intervention environment for the treatment of individuals with disorders in the abuse of drugs, alcohol, and other substances.
person
Provider's Taxonomy Details 5
Type
Suppliers
Classification
Indian Health Service/Tribal/Urban Indian Health (I/T/U) Pharmacy
Speciality
-
Taxonomy
332800000X
License No.
()
Definition
An Indian Health Service/Tribal/Urban Indian Health (I/T/U) Pharmacy means a pharmacy operated by the Indian Health Service, an Indian tribe or tribal organization, or an urban Indian organization, all of which are defined in Section 4 of the Indian Health Care Improvement Act, 25 U.S.C. 1603.
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