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Fort Defiance Outpatient Treatment Center
Community/Behavioral Health Agency in Fort Defiance, Arizona
NPI 1740400365

Fort Defiance Outpatient Treatment Center is a Community/Behavioral Health Agency based in Fort Defiance, AZ. Fort Defiance Outpatient Treatment Center practices in Fort Defiance, AZ. The NPI Number for Fort Defiance Outpatient Treatment Center is 1740400365 and holds a License No. (Arizona).

The current practice location address for Fort Defiance Outpatient Treatment Center is .5 Miles Sw Of The Fd Field House Bldg #6905, Fort Defiance, AZ and can be reached out via phone at 928-729-4012 and via fax at 928-729-4200.

Location: .5 Miles Sw Of The Fd Field House Bldg #6905, Fort Defiance, AZ, 86504-1490
Profile Details Legacy Identifiers Practice Address Mailing Address Primary Taxonomy
institution
Provider Profile Details
NPI Number
1740400365
Provider Name
Fort Defiance Outpatient Treatment Center
Credential
Provider Entity Type
Organization
Address
.5 Miles Sw Of The Fd Field House Bldg #6905, Fort Defiance, AZ, 86504-1490
Phone Number
928-729-4012
Fax Number
928-729-4200
Provider Enumeration Date
04/26/2007
Last Update Date
03/09/2024
tick
Provider's Legacy Identifiers
Identifier Type State Issuer
329541 05 AZ
institution
Provider Business Practice Location Address Details
Address
.5 Miles Sw Of The Fd Field House Bldg #6905
City
Fort Defiance
State
Arizona
Zip
86504-1490
Phone Number
928-729-4012
Fax Number
928-729-4200
person
Provider Business Mailing Address Details
Address
.5 Miles Sw Of The Fd Field House Bldg #6905
City
Fort Defiance
State
Arizona
Zip
86504-1490
Phone Number
928-729-4012
Fax Number
928-729-4200
person
Provider's Taxonomy Details 1
Type
Behavioral Health & Social Service Providers
Classification
Counselor
Speciality
Addiction (Substance Use Disorder)
Taxonomy
101YA0400X
License No.
()
Definition
Definition to come...
person
Provider's Taxonomy Details 2
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.
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