Organization · Type 2 NPI

Mogollon Treatment Center

Substance Use Disorder Rehabilitation Clinic/Center · Payson, AZ

NPI number 1245908763 Active

Practice location

306 W Aero Dr
Payson, AZ 85541-5405

Specialties and licenses

Taxonomy	Code	License
Substance Use Disorder Rehabilitation Clinic/Center Primary	261QR0405X	None listed

Substance Use Disorder Rehabilitation Clinic/Center: Definition to come...

2 other providers at this address

NPI record

NPI: 1245908763
Entity type: Organization (Type 2)
Issued: Aug 31, 2021
Last updated: Nov 1, 2023
Status: Active

Other names

<unavail>
Paradise Valley Recovery · doing business as
Paradise Valley Recovery · doing business as

Authorized official

Mr. Tyri Norman Blondal
Chief Operations Officer
(602) 516-2414

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About NPI 1245908763

Mogollon Treatment Center's National Provider Identifier is 1245908763, issued on Aug 31, 2021. The primary taxonomy on file is Substance Use Disorder Rehabilitation Clinic/Center (261QR0405X), and the practice location is in Payson, AZ. The record was last updated on Nov 1, 2023.