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Wayne A. Formica
Community/Behavioral Health Agency in Queen Creek, Arizona
NPI 1902092422

Wayne A. Formica is a Community/Behavioral Health Agency based in Queen Creek, AZ. Wayne A. Formica practices in Queen Creek, AZ. The NPI Number for Wayne A. Formica is 1902092422 and holds a License No. LPC 10413 (Arizona).

The current practice location address for Wayne A. Formica is 2055 W Fruit Tree Ln, Queen Creek, AZ and can be reached out via phone at 480-677-4804 and via fax at 480-677-4804. You can also correspond with Wayne A. Formica through the mailing address at 2055 W FRUIT TREE LN, QUEEN CREEK, AZ - 85242-6356 (mailing address contact number: 480-677-4804).

Location: 2055 W Fruit Tree Ln, Queen Creek, AZ, 85242-6356
Profile Details Legacy Identifiers Practice Address Mailing Address Primary Taxonomy
institution
Provider Profile Details
NPI Number
1902092422
Provider Name
Wayne A. Formica
Credential
Provider Entity Type
Organization
Address
2055 W Fruit Tree Ln, Queen Creek, AZ, 85242-6356
Phone Number
480-677-4804
Fax Number
480-677-4804
Provider Enumeration Date
09/18/2007
Last Update Date
03/09/2024
institution
Provider Business Practice Location Address Details
Address
2055 W Fruit Tree Ln
City
Queen Creek
State
Arizona
Zip
85242-6356
Phone Number
480-677-4804
Fax Number
480-677-4804
person
Provider Business Mailing Address Details
Address
2055 W Fruit Tree Ln
City
Queen Creek
State
Arizona
Zip
85242-6356
Phone Number
480-677-4804
Fax Number
480-677-4804
person
Provider's Taxonomy Details 1
Type
Agencies
Classification
Community/Behavioral Health
Speciality
-
Taxonomy
251S00000X
License No.
LPC 10413 (Arizona)
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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