Mingus Mountain Estate Residential Center Inc in Prescott Valley - Residential Treatment Facility, Emotionally Disturbed Children
Mingus Mountain Estate Residential Center Inc - NPI 1356358519
Mingus Mountain Estate Residential Center Inc is a Residential Treatment Facility, Emotionally Disturbed Children in Prescott Valley, Arizona. Mingus Mountain Estate Residential Center Inc practices all healthcare services and medical treatments related to Residential Treatment Facility, Emotionally Disturbed Children. The NPI Number for Mingus Mountain Estate Residential Center Inc is 1356358519. The last update date is 2023-06-19.
Mingus Mountain Estate Residential Center Inc's current location address is 2517 N Great Western Dr Ste P, Prescott Valley, Arizona. You can contact this provider via phone number 6023352068 and fax number 6023352066. The mailing address for Mingus Mountain Estate Residential Center Inc is 2517 N Great Western Dr Ste P, Prescott Valley, Arizona. To know further, please read the information below!
Provider Profile Detail
| Provider Organization | Mingus Mountain Estate Residential Center Inc |
|---|---|
| Address | 2517 N Great Western Dr Ste P, Prescott Valley, Arizona |
| Phone Number | 6023352068 |
| Fax Number | 6023352066 |
| Sole Proprietor | -- |
| Credentials | -- |
Authorized Official
| Title or Position | EXECUTIVE |
|---|---|
| Authorized Official Name | Copas Randy |
| Telephone Number | 6023352000 |
NPI Number Detail
| NPI Number | 1356358519 |
|---|---|
| Provider Enumeration Date | 2006-08-01 |
| Last Updated Date | 2023-06-19 |
Provider Mailing Address Detail
| Address | 2517 N Great Western Dr Ste P |
|---|---|
| City | Prescott Valley |
| State | Arizona (AZ) |
| Post Code | 863142597 |
| Phone Number | 6023352068 |
| Fax Number | 6023352066 |
Provider's Primary Taxonomy Detail
| Speciality | Residential Treatment Facility, Emotionally Disturbed Children |
|---|---|
| Taxonomy | 322D00000X |
| Licence No | BH-312 |
|
Definition: A residential facility that provides habilitation services and other care and treatment to children diagnosed with mental health illness, behavioral issues, and intellectual disabilities and are not able to live independently. |
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Post Comment/ Review Below
What is the Mingus Mountain Estate Residential Center Inc's unique identification number?
The Mingus Mountain Estate Residential Center Inc has been assigned the NPI (National Provider Identifier) Number 1356358519 by the Centers for Medicare & Medicaid Services (CMS). This 10-digit code serves as a unique identifier for the organization.
Could you please provide the complete street address where Mingus Mountain Estate Residential Center Inc is physically located?
The Mingus Mountain Estate Residential Center Inc is physically situated at the following address: 2517 N Great Western Dr Ste P, Prescott Valley, AZ, 863142597.
What is Mingus Mountain Estate Residential Center Inc's specialized area of practice, and what is the corresponding taxonomy classification code for this field?
The Mingus Mountain Estate Residential Center Inc's specialized field of practice is Residential Treatment Facility, Emotionally Disturbed Children, and the corresponding taxonomy code that categorizes this area of specialization is 322D00000X.
On what date did the Centers for Medicare & Medicaid Services issue the 1356358519 to Mingus Mountain Estate Residential Center Inc?
The Mingus Mountain Estate Residential Center Inc received its 1356358519 assignment from the Centers for Medicare & Medicaid Services on 2006-08-01.
As of what date were the details related to Mingus Mountain Estate Residential Center Inc most recently updated or revised?
The information pertaining to Mingus Mountain Estate Residential Center Inc, including its address, specialty, and other relevant details, was last updated or revised on 2023-06-19.