DALLAS DETOX CENTER
NPI 1689392987
Psychiatric Residential Treatment Facility in Weatherford, TX
- Organization
- Psychiatric Residential Treatment Facili...
- CLIA Number: 45D2275382
- CLIA Cert. Type: Other - DETOX & RESIDENTIAL SUD
- CLIA Exp. Date: 01-19-2027
About DALLAS DETOX CENTER
This page provides the complete NPI Profile along with additional information for Dallas Detox Center, a provider established in Weatherford, Texas operating as a Psychiatric Residential Treatment Facility. The healthcare provider is registered in the NPI registry with number 1689392987 assigned on August 2022. The practitioner's primary taxonomy code is 323P00000X. The provider is registered as an organization and their NPI record was last updated June 2026. The authorized official of this NPI record is Mr. Nicholas Adam Petrillo (Owner)
- NPI
- 1689392987 Verify this NPI
- Provider Name
- DALLAS DETOX CENTER
- Entity Type
- Organization
- Location Address
- 100 MARIAH DR WEATHERFORD, TX 76087
- Location Phone
- (888) 979-9503
- Mailing Address
- 100 MARIAH DR WEATHERFORD, TX 76087
- Mailing Phone
- (888) 979-9503
- Is Sole Proprietor?
- No
- Is Organization Subpart?
- No
- Enumeration Date
- 08-22-2022
- Last Update Date
- 06-24-2026
- Code Navigator
Location Map
Specialty - Primary Taxonomy
The NPI enumerator requires providers to submit at least one taxonomy code. A taxonomy code is a unique 10-character code that describes the healthcare provider type, classification, and the area of specialization. There could be only one primary taxonomy code per NPI record. For individual NPIs the license data is associated to the taxonomy code.
- Classification
Psychiatric Residential Treatment Facility
- Taxonomy Code
- 323P00000X
- Type
- Residential Treatment Facilities
- Taxonomy Description
- A residential treatment facility (RTF) is a facility or distinct part of a facility that provides to children and adolescents, a total, twenty-four hour, therapeutically planned group living and learning situation where distinct and individualized psychotherapeutic interventions can take place. Residential treatment is a specific level of care to be differentiated from acute, intermediate, and long-term hospital care, when the least restrictive environment is maintained to allow for normalization of the patient's surroundings. The RTF must be both physically and programmatically distinct if it is a part or subunit of a larger treatment program. An RTF is organized and professionally staffed to provide residential treatment of mental disorders to children and adolescents who have sufficient intellectual potential to respond to active treatment (that is, for whom it can reasonably be assumed that treatment of the mental disorder will result in an improved ability to function outside the RTF) for whom outpatient treatment, partial hospitalization or protected and structured environment is medically or psychologically necessary
Secondary Taxonomies
The provider has reported to the NPI enumerator additional taxonomy codes. Multiple taxonomy codes may represent subspecialties or other areas of specialization the provider maybe licensed to practice.
| No. | Taxonomy Code | Type | Classification / Specialization |
License No. (State) |
|---|---|---|---|---|
| 1 | 324500000X | Residential Treatment Facilities | Substance Abuse Rehabilitation Facility |
Insurance Plans Accepted
According to publicly available information the provider might be accepting the following health plans from these health insurance companies:
Specific plan information not avaialable, please contact the provider to verify if your insurance plan is accepted.
Specific plan information not avaialable, please contact the provider to verify if your insurance plan is accepted.
*Please verify directly with this provider to make sure your insurance plan is currently accepted.
Additional Identifiers
The NPI Enumerator encourages providers to submit additional identifiers with their NPI application although the submission of this information is optional. The additional identifier(s) section includes other numbers or codes currently or formerly used as an identifier for the provider by other public healthcare entities. The identifiers may include UPIN, NSC, OSCAR, DEA, Medicaid State or PIN identification numbers.
| Identifier | Type / Code | Identifier State | Identifier Issuer |
|---|---|---|---|
| 4814-4815 | OTHER (01) | TX | PRIVATE FUNDING |
CLIA Information
The Clinical Laboratory Improvement Amendments (CLIA) of 1988 applies to facilities or sites that test human specimens for health assessment or to diagnose, prevent, or treat disease. The CLIA Program sets standards for clinical laboratory testing and issues certificates. The NPI / CLIA crosswalk information for this NPI number is:
- CLIA Number
- 45D2275382
- Facility Type
- Other - DETOX & RESIDENTIAL SUD
- Certificate Effective Date
- January 20, 2025
- Certificate Expiration Date
- January 19, 2027
- Laboratory Director
- NICHOLAS PETRILLO
- Certificate Type
- Certificate of Waiver
- Certificate Type Description
- This CLIA certificate is issued to Dallas Detox Center to perform only waived tests. CLIA defines waived tests as simple tests with a low risk for an incorrect result. Waived tests include certain tests listed in CLIA regulations, tests cleared by the FDA for home use and tests approved by the FDA for waived status and that meet CLIA waiver criteria.
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Other Providers at the Same Location
The following 1 provider is registered at the same or a nearby location.
Frequently Asked Questions
The NPI number assigned to this healthcare provider is 1689392987, enumerated as an "organization" on August 22, 2022.
The provider is located at 100 MARIAH DR WEATHERFORD, TX 76087 and the phone number is (888) 979-9503.
Psychiatric Residential Treatment Facility with taxonomy code 323P00000X.
The provider might be accepting Accepts: Medicare and Medicaid. Please consult your insurance carrier or call the provider to verify.
