Mingus Mountain Estate Residential Center Inc
Mingus Mountain Estate Residential Center Inc is an Emotionally Disturbed Childrens' Residential Treatment Facility in Prescott Valley, Arizona. Licensed in Arizona. Registered with an NPI since 2006.
- Licensed in
- AZ
- In the registry since
- 2006
What do these letters mean?
- Inc — Incorporated
- A form of business registration, not a clinical qualification.
Practice location Address checks out
15801 E Don Carlos DrPrescott Valley, AZ 86315-4109
Phone: (602) 335-2068
Fax: (602) 335-2066
Show map & directions
Directions in Google Maps · Apple Maps · OpenStreetMap
Pin is approximate — placed at the ZIP-code centre, not the exact door.
Specialties & licences
| Emotionally Disturbed Childrens' Residential Treatment Facility (primary) | Taxonomy 322D00000X · Licence BH-312 (AZ) |
|---|
Record details
| NPI number | 1356358519 |
|---|---|
| Entity type | Organization (Type 2) |
| Organization subpart | No |
| Authorized official | Randy Copas — Executive Director · (602) 335-2000 |
| NPI enumerated | August 1, 2006 |
| Last updated in NPPES | June 19, 2023 |
| Certification date | June 19, 2023 |
| Mailing address | 2517 N Great Western Dr Ste P, Prescott Valley, AZ 86314-2597 |
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4558 N Miner Rd, Prescott Valley, AZ 86314 · (928) 777-3280