Mingus Mountain Estate Residencial Center, Inc.

LBN: Mingus Mountain Estate Residencial Center, Inc.
Mingus Mountain Estate Residencial Center, Inc. is an health care organization with primary practice located at Hc 76 Hwy 89 A N Junction 151 , Prescott Valley AZ 86312-6485. The organization recently has 2 registered licenses in different health care specialties including Nursing & Custodial Care Facilities / Assisted Living, Behavioral Disturbances, Residential Treatment Facilities / Residential Treatment Facility, Emotionally Disturbed Children. Nursing & Custodial Care Facilities / Assisted Living, Behavioral Disturbances is the primary health care specialty. Mingus Mountain Estate Residencial Center, Inc. can be contacted via phone (602) 335-2000, or through Banken, Chris via phone (602) 335-2000.

Contact Information

Primary practice address
Hc 76 Hwy 89 A N Junction 151 Prescott Valley AZ 86312-6485
Phone: (602) 335-2000
Fax:
Website:
Map and Directions
Authorized official contact:
Name: Banken, Chris
Phone: (602) 335-2000

Health care specialties

SpecialtyCodeLicense #State
Nursing & Custodial Care Facilities / Assisted Living, Behavioral Disturbances 3104A0630X BH-1487 Arizona
Residential Treatment Facilities / Residential Treatment Facility, Emotionally Disturbed Children 322D00000X BH-312 Arizona

Profile Details

NPI number 1467654814
LBN Legal business name Mingus Mountain Estate Residencial Center, Inc.
DBA Doing business as
Authorized official Banken, Chris
Entity Organization
Organization subpart 1 No
Enumeration date Jun 5th, 2007
Last updated Aug 22nd, 2020 - about 4 years ago

1 Some organizations, which are providing health care services, may consist of units or departments that provide different types of health care services or have several separate physical locations, where health care service is provided. These units, departments or physical locations are not themselves legal entities. However, each of them is part of the organization, which is a legal entity. The organization may decide whether its subparts, if it has any, should have their own NPI numbers. In case a subpart conducts any HIPAA standard transactions by itself, without its parent's involvement, it must have its own NPI number.

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Identifiers

StateTypeNumberIssuer
All States NPI 1467654814 NPPES
Arizona MEDICAID 590118
Arizona MEDICAID 497744
Arizona MEDICAID 498057

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