Provider records sourced from NPPES (CMS National Plan & Provider Enumeration System). Data current as of August 10, 2026.
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Dominique L Gist

Individual provider Mental Illness Community Based Residential Treatment Facility · NPI 1629674742

Dominique L Gist is a Mental Illness Community Based Residential Treatment Facility in Goodyear, Arizona. Practices as a sole proprietor. Registered with an NPI since 2020.

In the registry since
2020
Specialties on file
5
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Practice location Address checks out

8674 S 165th Ave
Goodyear, AZ 85338-1447
Phone: (313) 434-6821
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Pin is approximate — placed at the ZIP-code centre, not the exact door.

Specialties & licences

Psychiatric Residential Treatment Facility (primary) Taxonomy 323P00000X
Mental Illness Community Based Residential Treatment Facility Taxonomy 320800000X
Community/Behavioral Health Agency Taxonomy 251S00000X
Substance Abuse Rehabilitation Facility Taxonomy 324500000X
Indian Health Service/Tribal/Urban Indian Health (I/T/U) Pharmacy Taxonomy 332800000X

Record details

NPI number1629674742
Entity typeIndividual (Type 1)
GenderFemale
Sole proprietorYes
NPI enumeratedDecember 5, 2020
Last updated in NPPESDecember 5, 2020
Certification dateDecember 5, 2020

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