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MINGUS MOUNTAIN ESTATE RESIDENCIAL CENTER, INC.

Assisted Living, Behavioral Disturbances

Prescott Valley, Arizona

Provider NPI: 1467654814

Organization Information:
Organization Name:  MINGUS MOUNTAIN ESTATE RESIDENCIAL CENTER, INC.


Practice Location:
HC 76 HWY 89 A N JUNCTION 151  PRESCOTT VALLEY, AZ 86312 US
Tel: 602-335-2000  Fax: --

Business Mailing Address:
  ,   
Tel: --  Fax: --


Taxonomy:

PrimaryCodeCategory/DescriptionStateLicense Number
X3104A0630XNursing & Custodial Care Facilities
Assisted Living Facility
Assisted Living, Behavioral Disturbances
AZBH-1487
X322D00000XResidential Treatment Facilities
Residential Treatment Facility, Emotionally Disturbed Children
AZBH-312

Other Provider Identifiers:

IssuerNumberStateType
497744AZ05
498057AZ05
590118AZ05
Code values:
01, Other | 02, Medicare Upin | 04, Medicare Id-Type Unspecified
05, Medicaid | 06, Medicare Oscar/Certification | 07, Medicare NSC | 08, Medicare Pin




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