Organization
MOGOLLON TREATMENT CENTER
Active
Organization
MOGOLLON TREATMENT CENTER
Active
Parent organization
MOGOLLON TREATMENT CENTER
Other names
Paradise Valley Recovery
Organization subpart
Yes
Provider details
NPI number
Legal business name
MOGOLLON TREATMENT CENTER
Authorized official
MR. TYRI NORMAN BLONDAL (CHIEF OPERATIONS OFFICER)
(602) 516-2414
Entity
Organization
Contact information
Practice address
5402 E THOMAS RD, PHOENIX, AZ 85018-8107
(602) 516-2414
Mailing address
306 W AERO DR, PAYSON, AZ 85541-5405
(602) 516-2414
Taxonomy
Speciality
Code
Description
License number
State
324500000X
Substance Abuse Rehabilitation Facility
Primary
—
—
Other
Enumeration date
09/21/2023
Last updated
09/21/2023
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