Mingus Mountain Estate Residential Center INC
NPI #1356358519 in Prescott Valley, Arizona
Provider Information
- NPI Number
- 1356358519
- Entity Type
- Organization
- Organization Name
- Mingus Mountain Estate Residential Center INC
- Primary Specialty
- Residential Treatment Facility, Emotionally Disturbed Children
- Enumeration Date
- Aug 1, 2006
- Last Updated
- Jun 19, 2023
Practice Location
- Address
- 15801 E DON CARLOS DR
- City
- Prescott Valley
- State
- Arizona
- ZIP Code
- 86315-4109
- Phone
- (602) 335-2068
Authorized Official
- Name
- MR. RANDY COPAS
- Title
- EXECUTIVE DIRECTOR
- Phone
- (602) 335-2000
Specialties & Taxonomy Codes
| Specialty |
|---|
| Residential Treatment Facility, Emotionally Disturbed Children |
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