| Kaibeto Outpatient Treatment Center | |
|
0.5 Mile South Of Kaibeto Market Kaibeto AZ 86053-2147 | |
| (928) 673-3267 | |
| (928) 673-3269 |
| Full Name | Kaibeto Outpatient Treatment Center |
|---|---|
| Speciality | Community/behavioral Health |
| Location | 0.5 Mile South Of Kaibeto Market, Kaibeto, Arizona |
| Authorized Official Name and Position | Janell Dickson (BEHAVIORAL HEALTH DIRECTOR) |
| Authorized Official Contact | 9286733267 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Kaibeto Outpatient Treatment Center Po Box 2147 Kaibeto AZ 86053-2147 Ph: (928) 673-3267 | Kaibeto Outpatient Treatment Center 0.5 Mile South Of Kaibeto Market Kaibeto AZ 86053-2147 Ph: (928) 673-3267 |
| NPI Number | 1083835458 |
|---|---|
| Provider Enumeration Date | 05/01/2007 |
| Last Update Date | 03/10/2022 |
| Certification Date | 03/10/2022 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1083835458 | NPI | - | NPPES |
| 822909 | Medicaid | AZ |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 101YA0400X | Counselor - Addiction (substance Use Disorder) | 822909 (Arizona) | Secondary |
| 251S00000X | Community/behavioral Health | (* (Not Available)) | Primary |