Mogollon Treatment Center
NPI 1639047020 · Substance Abuse Rehabilitation Facility · Phoenix, AZ
Mogollon Treatment Center is a Substance Abuse Rehabilitation Facility organization in Phoenix, AZ (NPI 1639047020).
Provider details
- NPI number
- 1639047020
- Entity type
- Organization
- Primary specialty
- Substance Abuse Rehabilitation FacilityResidential Treatment Facilities
- Organization subpart
- No
- Authorized official
- Dustin Bullard, Owner(928) 466-4242
Specialties & taxonomies
Residential Treatment Facilities
Profile Score
A profile completeness & documented-activity index — NOT a quality, outcomes, or patient-satisfaction rating.
- Registry tenure38% of score
Under 1 yr in registry
- Profile completeness38% of score
100% of core fields populated
- Practice footprint23% of score
1 documented practice location
Signals a provider has no public data for (e.g. Medicare claims) are left out of the score entirely — never counted as zero — so providers without that data are not penalized. See the full formula and weights in our methodology.
Practice location
Mailing address
Registry dates
- Enumerated
- 2025-10-27
- Last updated
- 2025-12-12
- Certified
- 2025-12-12
Frequently asked questions
- What is Mogollon Treatment Center's NPI number?
- Mogollon Treatment Center's National Provider Identifier (NPI) is 1639047020, a unique 10-digit ID issued by CMS for use in standard healthcare transactions.
- What type of organization is Mogollon Treatment Center?
- Mogollon Treatment Center is classified in the NPPES registry as Substance Abuse Rehabilitation Facility (Residential Treatment Facilities).
- Where is Mogollon Treatment Center located?
- Mogollon Treatment Center's practice location on file with NPPES is 3338 W Kings Ave, Phoenix, AZ 85053-2940.
- What is Mogollon Treatment Center's phone number?
- The practice phone number listed in the NPPES registry for Mogollon Treatment Center is (928) 466-4242.
- Who is the authorized official for Mogollon Treatment Center?
- The authorized official listed on Mogollon Treatment Center's NPPES record is Dustin Bullard, Owner. The authorized official registers and maintains the organization's NPI and is not necessarily its owner.
- Is Mogollon Treatment Center's NPI active?
- Yes — Mogollon Treatment Center's NPI (1639047020) is active in the NPPES registry as of the last update on 2025-12-12.
Source: CMS NPPES Data Dissemination (June 2026). NPI Central is not affiliated with CMS. Data is provided as-is from the public registry.