Fort Defiance Outpatient Treatment Center in Fort Defiance - Addiction (substance Use Disorder)
Fort Defiance Outpatient Treatment Center - NPI 1740400365
Fort Defiance Outpatient Treatment Center is a Addiction (substance Use Disorder) in Fort Defiance, Arizona. Fort Defiance Outpatient Treatment Center practices all healthcare services and medical treatments related to Addiction (substance Use Disorder). The NPI Number for Fort Defiance Outpatient Treatment Center is 1740400365. The last update date is 2022-03-10.
Fort Defiance Outpatient Treatment Center's current location address is Po Box 1490, Fort Defiance, Arizona. You can contact this provider via phone number 9287294012 and fax number 9287294200. The mailing address for Fort Defiance Outpatient Treatment Center is Po Box 1490, Fort Defiance, Arizona. To know further, please read the information below!
Provider Profile Detail
| Provider Organization | Fort Defiance Outpatient Treatment Center |
|---|---|
| Address | Po Box 1490, Fort Defiance, Arizona |
| Phone Number | 9287294012 |
| Fax Number | 9287294200 |
| Sole Proprietor | -- |
| Credentials | -- |
Authorized Official
| Title or Position | BEHAVIORAL |
|---|---|
| Authorized Official Name | Blatchford Miranda |
| Credentials | LCSW |
| Telephone Number | 9287294012 |
NPI Number Detail
| NPI Number | 1740400365 |
|---|---|
| Provider Enumeration Date | 2007-04-26 |
| Last Updated Date | 2022-03-10 |
Provider Mailing Address Detail
| Address | Po Box 1490 |
|---|---|
| City | Fort Defiance |
| State | Arizona (AZ) |
| Post Code | 865041490 |
| Phone Number | 9287294012 |
| Fax Number | 9287294200 |
Provider's Primary Taxonomy Detail
| Speciality | Addiction (substance Use Disorder) |
|---|---|
| Taxonomy | 101Ya0400X |
|
Definition: A counselor who helps people with alcohol, drug, gambling, internet, and other types of addictions. |
|
Provider's Other Legacy Identifiers
| Identifier | Identifier Type | Identifier State | Identifier Issuer |
|---|---|---|---|
| 329541 | AZ | -- |
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What is the Fort Defiance Outpatient Treatment Center's 1740400365?
The Fort Defiance Outpatient Treatment Center's NPI (National Provider Identifier) Number is 1740400365. This unique 10-digit identification number is assigned to health care providers by the Centers for Medicare & Medicaid Services (CMS).
Can you provide the Fort Defiance Outpatient Treatment Center's physical address?
The Fort Defiance Outpatient Treatment Center is physically located at Po Box 1490, in the city of Fort Defiance, AZ, with the postal code 865041490.
What is Fort Defiance Outpatient Treatment Center's specialized area of practice, and what is the corresponding taxonomy classification code for this field?
The Fort Defiance Outpatient Treatment Center's specialized field of practice is Addiction (substance Use Disorder), and the corresponding taxonomy code that categorizes this area of specialization is 101Ya0400X.
When did Fort Defiance Outpatient Treatment Center receive its 1740400365 assignment?
The Fort Defiance Outpatient Treatment Center was assigned its 1740400365 on 2007-04-26, which is the date when this unique identifier was issued to the organization.
As of what date was the information pertaining to Fort Defiance Outpatient Treatment Center, such as address, specialty, and other details, last reviewed and confirmed to be accurate?
The information related to Fort Defiance Outpatient Treatment Center, including its address, specialty, and other relevant details, was last reviewed and confirmed to be accurate on 2022-03-10.