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MINGUS MOUNTAIN ESTATE RESIDENTIAL CENTER INC

Assisted Living, Behavioral Disturbances

Dewey, Arizona

Provider NPI: 1114090925

Organization Information:
Organization Name:  MINGUS MOUNTAIN ESTATE RESIDENTIAL CENTER INC


Practice Location:
100 DEWEY ROAD FARRINGTON HOME DEWEY, AZ 86327 US
Tel: 602-335-2095  Fax: --

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


Taxonomy:

PrimaryCodeCategory/DescriptionStateLicense Number
Y3104A0630XNursing & Custodial Care Facilities
Assisted Living Facility
Assisted Living, Behavioral Disturbances
AZBH-1122

Other Provider Identifiers:

IssuerNumberStateType
497744AZ05
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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