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MOGOLLON TREATMENT CENTER
NPI 1831053081
Substance Abuse Rehabilitation Facility in Payson, AZ

Active since December 12, 2025
300 W WADE LN, PAYSON, AZ 85541(928) 466-4242(928) 474-7460 Get Directions Write a Review

NPPES record last updated: December 12, 2025. Verified against the NPPES registry weekly; last sync: August 23, 2026.

About Mogollon Treatment Center NPPES

Official registry information on file with the National Plan and Provider Enumeration System.

MOGOLLON TREATMENT CENTER (NPI 1831053081) is a healthcare organization registered as a substance abuse rehabilitation facility in Payson, Arizona and active in the NPI registry since December 2025. The organization lists Dustin Heracles Bullard, Owner, as its authorized official.

NPPES Registry Identity

NPI1831053081
Entity TypeOrganization
Primary Taxonomy324500000X
Legal Business NameMOGOLLON TREATMENT CENTER
Location Address300 W WADE LNPayson, AZ 85541-4873
Mailing Address306 W Aero DrPayson, AZ 85541-5405 · (928) 466-4242 · Fax (928) 474-7460
Phone(928) 466-4242
Fax(928) 474-7460
Organization SubpartNo
Authorized OfficialDustin Heracles BullardOwner · (928) 466-4242
Enumeration DateDecember 12, 2025
NPPES CertifiedDecember 12, 2025
✔ NPI 1831053081 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtySubstance Abuse Rehabilitation FacilityResidential Treatment Facilities
Taxonomy Code324500000X
Definition
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.
300 W WADE LN, Payson, AZ 85541
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Frequently 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 1831053081. It was assigned to this organization in the NPPES registry on December 12, 2025.

Where is Mogollon Treatment Center located?

Mogollon Treatment Center is located at 300 W Wade Ln, Payson, AZ 85541. The listed phone number is (928) 466-4242.

What is Mogollon Treatment Center's specialty?

The primary specialty registered for this NPI is Substance Abuse Rehabilitation Facility with taxonomy code 324500000X.

When was this NPI record last updated?

The NPPES record for Mogollon Treatment Center was last updated on December 12, 2025. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 8 months 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.