MOGOLLON TREATMENT CENTER
NPI: 1750160511
· PHOENIX, AZ 85018
· Substance Abuse Rehabilitation Facility
· NPI assigned 09/21/2023
$425K
Total Medicaid Paid
Provider Details
| Authorized Official | BLONDAL, TYRI (CHIEF OPERATIONS OFFICER) |
| Parent Organization | MOGOLLON TREATMENT CENTER |
| NPI Enumeration Date | 09/21/2023 |
Related Entities
Other providers sharing the same authorized official: BLONDAL, TYRI
Monthly Spending Trend
Yearly Breakdown
| Year | Claims | Total Paid |
|---|
| 2024 |
2,080 |
$425K |
Billing Codes
| Code | Description | Claims | Bene. Records | Total Paid |
|---|
| H0018 |
Behavioral health; short-term residential (non-hospital residential treatment program), without room and board, per diem |
2,080 |
138 |
$425K |