MOGOLLON TREATMENT CENTER
NPI 1750160511
Substance Abuse Rehabilitation Facility in Phoenix, AZ
About Mogollon Treatment Center NPPES
Official registry information on file with the National Plan and Provider Enumeration System.
MOGOLLON TREATMENT CENTER (NPI 1750160511), doing business as Paradise Valley Recovery, is a healthcare organization registered as a substance abuse rehabilitation facility in Phoenix, Arizona and active in the NPI registry since September 2023. The organization holds a CLIA Waiver certificate valid through July 19, 2027 and lists Tyri Norman Blondal, Chief Operations Officer, as its authorized official.
NPPES Registry Identity
Specialties & Licenses
Other Names 1
Accepted Insurance
CLIA Laboratory Certificates CMS CLIA
Laboratory certificates issued under the Clinical Laboratory Improvement Amendments (CLIA) program, which sets federal quality standards for human laboratory testing in the United States. There is no official CMS crosswalk between CLIA and NPI numbers; these certificates are associated with this NPI by matching facility names, locations and phone numbers in the CMS CLIA registry.
Certificate of Waiver 03D2285971
Mogollon Treatment Center Dba Paradise Valley Recovery · Phoenix, AZFrequently Asked Questions NPPES & CMS
Common questions about this NPI record, answered from the official NPPES registry and CMS datasets shown on this page.
What is Mogollon Treatment Center's NPI number?
The NPI number for Mogollon Treatment Center is 1750160511. It was assigned to this organization in the NPPES registry on September 21, 2023. The provider is doing business as Paradise Valley Recovery.
Where is Mogollon Treatment Center located?
Mogollon Treatment Center is located at 5402 E Thomas Rd, Phoenix, AZ 85018. The listed phone number is (602) 516-2414.
What is Mogollon Treatment Center's specialty?
The primary specialty registered for this NPI is Substance Abuse Rehabilitation Facility with taxonomy code 324500000X.
Does Mogollon Treatment Center hold a CLIA laboratory certificate?
Yes. A Certificate of Waiver (number 03D2285971) is associated with this NPI, valid through July 19, 2027. CLIA certificates authorize laboratory testing under the federal Clinical Laboratory Improvement Amendments program.
What insurance does Mogollon Treatment Center accept?
Health plans from Blue Cross Blue Shield of Arizona list Mogollon Treatment Center as in-network in at least one marketplace plan. Coverage varies by plan and year; verify with the insurer or the provider before a visit.
When was this NPI record last updated?
The NPPES record for Mogollon Treatment Center was last updated on September 21, 2023. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 2 years ago. If this record has changed at CMS more recently, you can request an on-demand re-check against the live CMS registry, directly from this page.
# Mogollon Treatment Center · NPI 1750160511
Substance Abuse Rehabilitation Facility organization in Phoenix, Arizona. Organization record, active in the CMS NPPES registry since September 21, 2023.
## Identity
- **NPI:** 1750160511 (Entity type: Organization)
- **Enumerated:** September 21, 2023
- **Primary specialty:** Substance Abuse Rehabilitation Facility · taxonomy 324500000X
- **Also known as:** Paradise Valley Recovery (Doing Business As)
- **Organization subpart:** Yes (part of Mogollon Treatment Center)
- **Authorized official:** Tyri Blondal, CHIEF OPERATIONS OFFICER
## Practice location
- **Address:** 5402 E THOMAS RD, Phoenix, AZ 85018-8107
- **Phone:** (602) 516-2414
## Record status
- **NPPES last updated:** September 21, 2023
- **CLIA laboratory certificates:** 1 on file
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Source: [NPI Profile](https://npiprofile.com/npi/1750160511) · Data from the CMS NPPES public registry.