Organization
MOGOLLON BEHAVIORAL HEALTH INC.
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MICHAEL ZACHARY PERRINO (MANAGING DIRECTOR)
(928) 910-2237
Entity
Organization
Contact information
Practice address
7103 N BLACK CANYON HWY, PHOENIX, AZ 85021-7619
(602) 377-4730
Mailing address
7103 N BLACK CANYON HWY, PHOENIX, AZ 85021-7619
Taxonomy
Speciality
Code
Description
License number
State
261QR0401X
Comprehensive Outpatient Rehabilitation Facility (CORF)
Primary
—
—
Other
Enumeration date
11/07/2024
Last updated
11/07/2024
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