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Mingus Mountain Estate Residencial Center, Inc.
Emotionally Disturbed Childrens' Residential Treatment Facility in Prescott Valley, Arizona
NPI 1467654814

Mingus Mountain Estate Residencial Center, Inc. is a Emotionally Disturbed Childrens' Residential Treatment Facility based in Prescott Valley, AZ. Mingus Mountain Estate Residencial Center, Inc. practices in Prescott Valley, AZ. The NPI Number for Mingus Mountain Estate Residencial Center, Inc. is 1467654814 and holds a License No. BH-1487 (Arizona).

The current practice location address for Mingus Mountain Estate Residencial Center, Inc. is Hc 76 Hwy 89 A N Junction 151, Prescott Valley, AZ and can be reached out via phone at 602-335-2000.

Location: Hc 76 Hwy 89 A N Junction 151, Prescott Valley, AZ, 86312-6485
Profile Details Legacy Identifiers Practice Address Mailing Address Primary Taxonomy
institution
Provider Profile Details
NPI Number
1467654814
Provider Name
Mingus Mountain Estate Residencial Center, Inc.
Credential
Provider Entity Type
Organization
Address
Hc 76 Hwy 89 A N Junction 151, Prescott Valley, AZ, 86312-6485
Phone Number
602-335-2000
Fax Number
Provider Enumeration Date
06/05/2007
Last Update Date
03/09/2024
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Provider's Legacy Identifiers
Identifier Type State Issuer
590118 05 AZ
497744 05 AZ
498057 05 AZ
institution
Provider Business Practice Location Address Details
Address
Hc 76 Hwy 89 A N Junction 151
City
Prescott Valley
State
Arizona
Zip
86312-6485
Phone Number
602-335-2000
Fax Number
person
Provider Business Mailing Address Details
Address
Hc 76 Hwy 89 A N Junction 151
City
Prescott Valley
State
Arizona
Zip
86312-6485
Phone Number
602-335-2000
Fax Number
person
Provider's Taxonomy Details 1
Type
Nursing & Custodial Care Facilities
Classification
Assisted Living Facility
Speciality
Assisted Living, Behavioral Disturbances
Taxonomy
3104A0630X
License No.
BH-312 (Arizona)
Definition
A facility providing supportive services to individuals who can function independently in most areas of activity, but exhibit abnormal behavioral responses and habits and therefore need special guidance, assistance and/or monitoring to assure safety and well being. This type of facility requires a staff with special training in dealing with and redirecting negative, violent or destructive behaviors.
person
Provider's Taxonomy Details 2
Type
Residential Treatment Facilities
Classification
Residential Treatment Facility, Emotionally Disturbed Children
Speciality
-
Taxonomy
322D00000X
License No.
BH-1487 (Arizona)
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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