Provider records sourced from NPPES (CMS National Plan & Provider Enumeration System). Data current as of August 10, 2026.

Mogollon Treatment Center

Organization Substance Abuse Rehabilitation Facility · NPI 1639047020

Mogollon Treatment Center is a Substance Abuse Rehabilitation Facility in Phoenix, Arizona. Registered with an NPI since 2025.

In the registry since
2025

Practice location Address checks out

3338 W Kings Ave
Phoenix, AZ 85053-2940
Phone: (928) 466-4242
Show map & directions

Pin is approximate — placed at the ZIP-code centre, not the exact door.

Specialties & licences

Substance Abuse Rehabilitation Facility (primary) Taxonomy 324500000X

Record details

NPI number1639047020
Entity typeOrganization (Type 2)
Organization subpartNo
Authorized official Dustin Bullard — Owner · (928) 466-4242
NPI enumeratedOctober 27, 2025
Last updated in NPPESDecember 12, 2025
Certification dateDecember 12, 2025
Mailing address306 W Aero Dr, Payson, AZ 85541-5405

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