KAIBETO OUTPATIENT TREATMENT CENTER — NPI 1083835458 (Licensed & Credentialed Community/Behavioral Health in KAIBETO, AZ)

CMS-1500 Box 24J / 33a • NPI

1083835458

Type 2 Organization (Box 32a/33a)

HIPAA NUCC Taxonomy • CMS Code

251S00000X

Licensed & Credentialed Community/Behavioral Health

Box 32 Service Location & ZIP+4

1/4 MILE SOUTH OF KAIBETO MARKET BLDG 7986, KAIBETO, AZ, 86053-2147

✓ 9-Digit EDI 837 ZIP+4 (86053-2147)

Practice Phone & Referral Fax

(928) 673-3267

Fax: (928) 673-3269

✓ HHS OIG LEIE Sanction Screening — VERIFIED CLEAR: NPI 1083835458 (KAIBETO OUTPATIENT TREATMENT CENTER) has 0 active federal exclusions across all 84,224 HHS OIG LEIE sanction records (Database Verified: 2026-11-11).

CMS Medicare Order & Referring PECOS Eligibility

Institutional Type-2 NPI facilities enroll via CMS-855A institutional provider agreements rather than individual Order & Referring PECOS.

Official CMS NPPES Credential & Practice Profile

10-Digit NPI Number	`1083835458` (NPI-2 Organization / Facility)
Provider / Legal Name	KAIBETO OUTPATIENT TREATMENT CENTER
Plain-English Specialty	Licensed & Credentialed Community/Behavioral Health NUCC Code: `251S00000X` (Community/Behavioral Health)
Certifying / Licensing Body	State Medical / Healthcare Licensing Board & National Specialty Board
Practice Location Address	1/4 MILE SOUTH OF KAIBETO MARKET BLDG 7986, KAIBETO, AZ, 86053-2147
Practice Telephone / Fax	Tel: (928) 673-3267 \| Fax: (928) 673-3269
Administrative Mailing Address	PO BOX 2147, KAIBETO, AZ, 86053-2147
Enumeration & Last Sync	Enumerated: 2007-05-01 \| CMS Record Updated: 2026-08-05
Authorized Official	JANELL DICKSON (Behavioral Health Director)

Clinic Location, Accessibility & Directions

📍 Practice Location & Patient Access

1/4 MILE SOUTH OF KAIBETO MARKET BLDG 7986, KAIBETO, AZ, 86053-2147

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Plain-English Taxonomy & CMS Crosswalk (251S00000X)

What Does Taxonomy Code 251S00000X Mean?

In the HIPAA National Uniform Claim Committee (NUCC) classification, code 251S00000X translates to:
"Licensed & Credentialed Community/Behavioral Health"

CMS-1500 Medicare Specialty Crosswalk: Standard HIPAA X12N 837P / CMS-1500
Certifying / Accrediting Authority: State Medical / Healthcare Licensing Board & National Specialty Board
Clinical Scope: Consult a verified Community/Behavioral Health for specialized diagnostic evaluation, treatment planning, and continuity of care.

Specialty Clinical Procedures & Therapeutic Classes

Standard Scope of Care (KAIBETO OUTPATIENT TREATMENT CENTER)

Typical CPT / Diagnostic Procedures:

Comprehensive Outpatient & Inpatient Clinical Evaluation (CPT 99202–99215)
Diagnostic Workup, Laboratory Ordering & Evidence-Based Care Coordination
Preventive Screening, Patient Counseling & Multidisciplinary Referral

Common Therapeutic Classes:

Evidence-Based Specialty Pharmacotherapy & Preventive Regimens (CMS Part D Standard)

All Registered NUCC Taxonomies & State Licenses

Taxonomy Code & Plain-English Description	State License & Primary Status
`101YA0400X` — Counselor, Addiction (Substance Use Disorder) Plain English: Licensed & Credentialed Counselor, Addiction (Substance Use Disorder)	State: AZ \| License: `822909` \| Primary: Secondary
`251S00000X` — Community/Behavioral Health Plain English: Licensed & Credentialed Community/Behavioral Health	State: N/A \| License: `Verified` \| Primary: Yes (Primary)

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KAIBETO OUTPATIENT TREATMENT CENTER (NPI #1083835458)