Fort Defiance Outpatient Treatment Center
NPI #1740400365 in Fort Defiance, Arizona
Provider Information
- NPI Number
- 1740400365
- Entity Type
- Organization
- Organization Name
- Fort Defiance Outpatient Treatment Center
- Primary Specialty
- Community/Behavioral Health
- Enumeration Date
- Apr 26, 2007
- Last Updated
- Mar 10, 2022
Practice Location
- Address
- .5 MILES SW OF THE FD FIELD HOUSE BLDG #6905
- City
- Fort Defiance
- State
- Arizona
- ZIP Code
- 86504-1490
- Phone
- (928) 729-4012
Authorized Official
- Name
- MIRANDA BLATCHFORD, LCSW
- Title
- BEHAVIORAL HEALTH DIRECTOR
- Phone
- (928) 729-4012
Specialties & Taxonomy Codes
| Specialty |
|---|
| Counselor - Addiction (Substance Use Disorder) — Addiction (Substance Use Disorder) |
| Community/Behavioral Health |
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