Data from the NPPES registry. May not reflect recent changes — verify at nppes.cms.hhs.gov.
DOMINIQUE L GIST
Active Sole ProprietorPsychiatric Residential Treatment Facility · GOODYEAR, AZ
Registration Details
- NPI Number
- 1629674742
- Provider Type
- Individual
- Gender
- Female
- NPI Issued
- Dec 5, 2020 (5.3773821873599 yrs)
- Last Updated
- Dec 5, 2020
- Sole Proprietor
- Yes
Practice Information
- Address
-
8674 S 165TH AVEGOODYEAR, AZ, 853381447Browse AZ providers · Browse ZIP 85338
- Phone
- 3134346821
- Primary Specialty
-
Psychiatric Residential Treatment Facility
323P00000X
- Additional Specialty
- Community/Behavioral Health
- Additional Specialty
- Substance Abuse Rehabilitation Facility
- Additional Specialty
- Indian Health Service Pharmacy
- Additional Specialty
- Psychiatric Residential Treatment Facility
Data sourced from the NPPES National Provider Identifier registry. This information is for informational purposes only and is not a substitute for verifying credentials with the appropriate licensing authority. For official verification, use the NPPES NPI Registry or the relevant state medical board.