MOGOLLON TREATMENT CENTER
NPI 1063225233
Substance Abuse Rehabilitation Facility in Payson, AZ
NPI Status: Active since January 30, 2025
Contact Information
212 W WADE LN
PAYSON, AZ
ZIP 85541
Phone: (928) 466-4242
Fax: (928) 474-7460
- Organization
- Substance Abuse Rehabilitation Facility
- Accepts Insurance
- CLIA Number: 03D2338949
- CLIA Cert. Type: Other - SUBSTANCE ABUSE RESIDENTI
- CLIA Exp. Date: 02-19-2028
About MOGOLLON TREATMENT CENTER
This page provides the complete NPI Profile along with additional information for Mogollon Treatment Center, a provider established in Payson, Arizona operating as a Substance Abuse Rehabilitation Facility. The healthcare provider is registered in the NPI registry with number 1063225233 assigned on January 2025. The practitioner's primary taxonomy code is 324500000X. The provider is registered as an organization and their NPI record was last updated one year ago. The authorized official of this NPI record is Tyri Norman Blondal Lmsw (Coo)
- NPI
- 1063225233
- Provider Name
- MOGOLLON TREATMENT CENTER
- Entity Type
- Organization
- Location Address
- 212 W WADE LN PAYSON, AZ 85541
- Location Phone
- (928) 466-4242
- Location Fax
- (928) 474-7460
- Mailing Address
- 306 W AERO DR PAYSON, AZ 85541
- Mailing Phone
- (602) 516-2414
- Mailing Fax
- (928) 474-7460
- Is Sole Proprietor?
- No
- Is Organization Subpart?
- Yes
- Enumeration Date
- 01-30-2025
- Last Update Date
- 01-30-2025
- 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
Substance Abuse Rehabilitation Facility
- Taxonomy Code
- 324500000X
- Type
- Residential Treatment Facilities
- Taxonomy Description
- A facility or distinct part of a facility that provides a 24 hr therapeutically planned living and rehabilitative intervention environment for the treatment of individuals with disorders in the abuse of drugs, alcohol, and other substances.
Insurance Plans Accepted
According to publicly available information the provider might be accepting the following health plans from these health insurance companies:
- AZ Blue ACA StandardHealth Silver with Health Choice - HMO
*Please verify directly with this provider to make sure your insurance plan is currently accepted.
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
- 03D2338949
- Facility Type
- Other - SUBSTANCE ABUSE RESIDENTI
- Certificate Effective Date
- February 20, 2026
- Certificate Expiration Date
- February 19, 2028
- Laboratory Director
- RYLIE E. PERKES
- Certificate Type
- Certificate of Waiver
- Certificate Type Description
- This CLIA certificate is issued to Mogollon Treatment 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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NPI NPI Number Validation
How NPI Validation Works
The NPI validation process uses the ISO-standard Luhn algorithm, a mathematical "handshake", to ensure that a provider's 10-digit ID is authentic and free of common typing errors.
To verify the NPI 1063225233, we treat the final digit (3) as the Check Digit—the target answer we need to reach. The process begins by taking the first nine digits and adding a constant value of 24, which accounts for the "80840" prefix required for all U.S. health identifiers. We then double every other digit starting from the right and sum the individual digits of those results together. For this specific NPI, that total comes to 47. The final step is to find the difference between that total and the next multiple of ten (50 - 47 = 3).
Digit-by-digit view
Use the first nine digits for the calculation. Starting from the right, double every other digit. The last digit is the check digit and is not part of the calculation.
Step 1: Double every other digit from the right
Starting with the rightmost digit of the first nine digits, double every other value. If doubling creates a two-digit number, add those digits together.
Step 2: Add all digits plus the NPI constant
Add the transformed values, the unchanged digits, and the constant 24.
Step 3: Find the amount needed to reach the next multiple of 10
The next multiple of ten after 47 is 50. The difference is the calculated check digit.
Frequently Asked Questions
The NPI number assigned to this healthcare provider is 1063225233, enumerated as an "organization" on January 30, 2025.
The provider is located at 212 W WADE LN PAYSON, AZ 85541 and the phone number is (928) 466-4242.
Substance Abuse Rehabilitation Facility with taxonomy code 324500000X.
The provider might be accepting Accepts: Blue Cross Blue Shield of Arizona. Please consult your insurance carrier or call the provider to verify.
