MINGUS MOUNTAIN ESTATE RESIDENTIAL CENTER INC (NPI# 1023441862) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1023441862 |
| Entity Type | Organization |
| Organization Name | MINGUS MOUNTAIN ESTATE RESIDENTIAL CENTER INC |
| Other Organization Name | MINGUS MOUNTAIN ACADEMY |
| Practice Address |
2430 W White Feather Ln Phoenix AZ 85085-4794 |
| Mailing Address |
Po Box 26485 Prescott Valley AZ 86312-6485 |
| Practice Telephone | 6237804882 |
| Practice Fax Number | 6024761910 |
| Mailing Telephone | 6023352000 |
| Mailing Fax Number | 6024761910 |
| Enumeration Date | 2013-08-15 |
| Last Update Date | 2013-08-15 |
| Authorized Official Name | MICHAEL MCFARLAND (EXECUTIVE DIRECTOR) |
| Authorized Official Telephone | 6023352000 |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 3104A0630X |
Assisted Living Facility Specialization: Assisted Living, Behavioral Disturbances |
BH4327 | AZ | Nursing & Custodial Care Facilities |
| Other Name | Type Code |
|---|---|
| Mingus Mountain Academy | Doing Business As Name - Organization |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1114090925 | Mingus Mountain Estate Residential Center Inc | Assisted Living Facility | 100 Dewey Road, Farrington Home, Dewey, AZ 86327 | 2006-11-17 |
| Street Address |
2430 W WHITE FEATHER LN |
| City | PHOENIX |
| State | AZ |
| Zip Code | 85085-4794 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1083844112 | United Youth and Family Services | Residential Treatment Facility, Emotionally Disturbed Children | 2430 W White Feather Ln, Phoenix, AZ 85085-4794 | 2009-07-23 |
| 1568707271 | Ascend Behavioral Health | Residential Treatment Facility, Emotionally Disturbed Children | 2430 W White Feather Ln, Phoenix, AZ 85085-4794 | 2012-12-06 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1235748369 | Nicole Fountain | Speech-Language Pathologist | 25700 N. 21st Avenue, Phoenix, AZ 85085 | 2020-07-24 |
| 1083138010 | Larry Leforte II | Emergency Medical Technician, Paramedic | 2018 W Blaylock Dr, Phoenix, AZ 85085 | 2017-08-01 |
| 1508318809 | Jennifer Falk | Chiropractor | 1614 W Whispering Wind Dr Ste 3, Phoenix, AZ 85085 | 2016-11-03 |
| 1053785964 | Cvs Pharmacy | Pharmacy | 28635 N North Vally Parkway, Phoenix, AZ 85085 | 2015-11-17 |
| 1417329897 | Kelly Criswell | Registered Nurse | 32150 N North Foothills Dr, Phoenix, AZ 85085 | 2015-10-26 |
| 1417333717 | Kristi Everett | Social Worker | 34225 N 27th Dr Bldg 5 Ste 146, Phoenix, AZ 85085 | 2015-08-10 |
| 1063849834 | Albertsons Pharmacy | Pharmacist | 2406 W Bramble Berry Ln, Phoenix, AZ 85085 | 2013-10-10 |
| 1427354851 | Carolyn Berg Newsome | Marriage & Family Therapist | 2060 W.whispering Wind Drive, Phoenix, AZ 85085 | 2011-02-02 |
| 1518273127 | Jamie Lynn Born | Social Worker | 34406 N 27th Dr Bldg 6, Phoenix, AZ 85085 | 2010-08-20 |
| 1023347218 | Lise Flores-reed | Psychologist | 34225 N. 27th Drive #110, Phoenix, AZ 85085 | 2009-12-17 |
| Find all providers in zip 85085 | ||||
| Taxonomy Code | 3104A0630X |
| Grouping | Nursing & Custodial Care Facilities |
| Classification | Assisted Living Facility |
| Specialization | Assisted Living, Behavioral Disturbances |
| 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. |
| Notes: [7/1/2003: new] |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1114536752 | The Heritage Behavioral Health Home LLC | Assisted Living Facility | 3927 W Rovey Ave, Phoenix, AZ 85019-1633 | 2020-07-29 |
| 1801420476 | Holy Trinity Behavioral,llc | Assisted Living Facility | 1630 W Nancy Ln, Phoenix, AZ 85041-5540 | 2020-02-23 |
| 1184258758 | Holy Trinity Behavioral,llc | Assisted Living Facility | 5308 W Vernon Ave, Phoenix, AZ 85035-1953 | 2020-02-23 |
| 1083261945 | D&g Behavioral Health LLC | Assisted Living Facility | 3119 N 46th Dr, Phoenix, AZ 85031-3705 | 2019-08-24 |
| 1881249902 | A Tender Hand Assisted Living Home, LLC, Dba | Assisted Living Facility | 6216 S 36th St, Phoenix, AZ 85042-4904 | 2019-08-06 |
| 1265098339 | Affinity of Hope Care Home | Assisted Living Facility | 7518 S 15th Dr, Phoenix, AZ 85041-6935 | 2019-05-14 |
| 1538625744 | N & T Behavioral Health LLC | Assisted Living Facility | 6150 W Cheery Lynn Rd, Phoenix, AZ 85033-5833 | 2019-02-12 |
| 1104381300 | Holy Trinity Behavioral,llc | Assisted Living Facility | 5208 W Avalon Dr, Phoenix, AZ 85031-3958 | 2019-02-01 |
| 1225592025 | Royal Behavioral Health LLC | Assisted Living Facility | 3845 W Mauna Loa Ln, Phoenix, AZ 85053-4538 | 2019-01-25 |
| 1629580717 | Brenton Casteel | Assisted Living Facility | 4638 E Summerhaven Dr, Phoenix, AZ 85044-4820 | 2017-10-29 |
| Find all providers in PHOENIX | ||||
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| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.