Organization
MOGOLLON TREATMENT CENTER
Active
Other names
Paradise Valley Recovery
Organization subpart
No
Provider details
NPI number
Authorized official
MR. TYRI NORMAN BLONDAL (CHIEF OPERATIONS OFFICER)
(602) 516-2414
Entity
Organization
Contact information
Practice address
306 W AERO DR, PAYSON, AZ 85541-5405
(714) 910-4286
Mailing address
306 W AERO DR, PAYSON, AZ 85541-5405
(714) 910-4286
Taxonomy
Speciality
Code
Description
License number
State
261QR0405X
Substance Use Disorder Rehabilitation Clinic/Center
Primary
—
—
Other
Enumeration date
08/31/2021
Last updated
11/01/2023
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