MINGUS MOUNTAIN ESTATE RESIDENTIAL CENTER INC
NPI 1356358519
Residential Treatment Facility, Emotionally Disturbed Children in Prescott Valley, AZ
NPI Status: Active since August 01, 2006
Contact Information
15801 E DON CARLOS DR
PRESCOTT VALLEY, AZ
ZIP 86315
Phone: (602) 335-2068
Fax: (602) 335-2066
- Organization
- Residential Treatment Facility, Emotiona...
- Accepts Insurance
- CLIA Number: 03D1096519
- CLIA Cert. Type: Other
- CLIA Exp. Date: 03-05-2027
About MINGUS MOUNTAIN ESTATE RESIDENTIAL CENTER INC
This page provides the complete NPI Profile along with additional information for Mingus Mountain Estate Residential Center Inc, a provider established in Prescott Valley, Arizona operating as a Residential Treatment Facility, Emotionally Disturbed Children. The healthcare provider is registered in the NPI registry with number 1356358519 assigned on August 2006. The practitioner's primary taxonomy code is 322D00000X with license number BH-312 (AZ). The provider is registered as an organization and their NPI record was last updated 3 years ago. The authorized official of this NPI record is Mr. Randy Copas (Executive Director)
- NPI
- 1356358519
- Provider Name
- MINGUS MOUNTAIN ESTATE RESIDENTIAL CENTER INC
- Entity Type
- Organization
- Location Address
- 15801 E DON CARLOS DR PRESCOTT VALLEY, AZ 86315
- Location Phone
- (602) 335-2068
- Location Fax
- (602) 335-2066
- Mailing Address
- 2517 N GREAT WESTERN DR STE P PRESCOTT VALLEY, AZ 86314
- Mailing Phone
- (602) 335-2068
- Mailing Fax
- (602) 335-2066
- Is Sole Proprietor?
- No
- Is Organization Subpart?
- No
- Enumeration Date
- 08-01-2006
- Last Update Date
- 06-19-2023
- Code Navigator
Location Map
Specialty - Primary Taxonomy
The NPI enumerator requires providers to submit at least one taxonomy code. A taxonomy code is a unique 10-character code that describes the healthcare provider type, classification, and the area of specialization. There could be only one primary taxonomy code per NPI record. For individual NPIs the license data is associated to the taxonomy code.
- Classification
Residential Treatment Facility, Emotionally Disturbed Children
- Taxonomy Code
- 322D00000X
- Type
- Residential Treatment Facilities
- License No.
- BH-312
- License State
- AZ
- Taxonomy Description
- 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.
Insurance Plans Accepted
According to publicly available information the provider might be accepting the following health plans from these health insurance companies:
- Choice Bronze HSA - HMO
- Choice Bronze HSA + Vision + Adult Dental - HMO
- Complete Gold - HMO
- Complete Gold + Vision + Adult Dental - HMO
- Complete Silver - HMO
- Complete Silver + Vision + Adult Dental - HMO
- Elite Gold - HMO
- Elite Gold + Vision + Adult Dental - HMO
- Everyday Bronze - HMO
- Everyday Bronze + Vision + Adult Dental - HMO
- Standard Expanded Bronze - HMO
- Standard Expanded Bronze + Vision + Adult Dental - HMO
- Standard Gold - HMO
- Standard Gold + Vision + Adult Dental - HMO
- Standard Silver - HMO
- Standard Silver + Vision + Adult Dental - HMO
- Complete Gold - EPO
- Complete Gold + Vision + Adult Dental - EPO
- Enhanced Diabetes Care Silver with $0 Drug Options - EPO
- Enhanced Diabetes Care Silver with $0 Drug Options + Vision + Adult Dental - EPO
- Everyday Gold - EPO
- Everyday Gold + Vision + Adult Dental - EPO
- Focused Silver - EPO
- Focused Silver + Vision + Adult Dental - EPO
- Standard Gold - EPO
- Standard Gold + Vision + Adult Dental - EPO
- Standard Silver - EPO
- Standard Silver + Vision + Adult Dental - EPO
- Elite Bronze - PPO
- Elite Bronze + Vision + Adult Dental - PPO
- Elite Gold - PPO
- Elite Gold + Vision + Adult Dental - PPO
- Enhanced Asthma/COPD Care Silver with $0 Drug Options - PPO
- Enhanced Asthma/COPD Care Silver with $0 Drug Options + Vision + Adult Dental - PPO
- Enhanced Diabetes Care Silver with $0 Drug Options - PPO
- Enhanced Diabetes Care Silver with $0 Drug Options + Vision + Adult Dental - PPO
- Everyday Bronze - PPO
- Everyday Bronze + Vision + Adult Dental - PPO
- Everyday Gold - PPO
- Everyday Gold + Vision + Adult Dental - PPO
- Focused Silver - PPO
- Focused Silver + Vision + Adult Dental - PPO
- Standard Expanded Bronze - PPO
- Standard Expanded Bronze + Vision + Adult Dental - PPO
- Standard Gold - PPO
- Standard Gold + Vision + Adult Dental - PPO
- Standard Silver - PPO
- Standard Silver + Vision + Adult Dental - PPO
- AZ Blue AdvanceHealth Bronze Focus (4 Free PCP Visits) - HMO
- AZ Blue AdvanceHealth Bronze Neighborhood (4 Free PCP Visits) - HMO
- AZ Blue AdvanceHealth Gold Focus (4 Free PCP Visits) - HMO
- AZ Blue AdvanceHealth Gold Neighborhood (4 Free PCP Visits) - HMO
- AZ Blue AdvanceHealth Silver Focus (4 Free PCP Visits) - HMO
- AZ Blue AdvanceHealth Silver Neighborhood (4 Free PCP Visits) - HMO
- AZ Blue EverydayHealth Gold Focus (1 Free PCP Visit) - HMO
- AZ Blue EverydayHealth Gold Neighborhood (1 Free PCP Visit) - HMO
- AZ Blue EverydayHealth Silver Focus (1 Free PCP Visit) - HMO
- AZ Blue EverydayHealth Silver Neighborhood (1 Free PCP Visit) - HMO
- AZ Blue Portfolio Bronze HSA Focus - HMO
- AZ Blue Portfolio Bronze HSA Neighborhood - HMO
- AZ Blue StandardHealth Bronze Focus - HMO
- AZ Blue StandardHealth Bronze Neighborhood - HMO
- AZ Blue StandardHealth Gold Focus - HMO
- AZ Blue StandardHealth Gold Neighborhood - HMO
- AZ Blue StandardHealth Silver Focus - HMO
- AZ Blue StandardHealth Silver Neighborhood - HMO
*Please verify directly with this provider to make sure your insurance plan is currently accepted.
CLIA Information
The Clinical Laboratory Improvement Amendments (CLIA) of 1988 applies to facilities or sites that test human specimens for health assessment or to diagnose, prevent, or treat disease. The CLIA Program sets standards for clinical laboratory testing and issues certificates. The NPI / CLIA crosswalk information for this NPI number is:
- CLIA Number
- 03D1096519
- Facility Type
- Other
- Certificate Effective Date
- March 06, 2025
- Certificate Expiration Date
- March 05, 2027
- Laboratory Director
- SHANNON MCBROOM
- Certificate Type
- Certificate of Waiver
- Certificate Type Description
- This CLIA certificate is issued to Mingus Mountain Estate Residential Center Inc to perform only waived tests. CLIA defines waived tests as simple tests with a low risk for an incorrect result. Waived tests include certain tests listed in CLIA regulations, tests cleared by the FDA for home use and tests approved by the FDA for waived status and that meet CLIA waiver criteria.
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NPI NPI Number Validation
How NPI Validation Works
The NPI validation process uses the ISO-standard Luhn algorithm, a mathematical "handshake", to ensure that a provider's 10-digit ID is authentic and free of common typing errors.
To verify the NPI 1356358519, we treat the final digit (9) as the Check Digit—the target answer we need to reach. The process begins by taking the first nine digits and adding a constant value of 24, which accounts for the "80840" prefix required for all U.S. health identifiers. We then double every other digit starting from the right and sum the individual digits of those results together. For this specific NPI, that total comes to 61. The final step is to find the difference between that total and the next multiple of ten (70 - 61 = 9).
Digit-by-digit view
Use the first nine digits for the calculation. Starting from the right, double every other digit. The last digit is the check digit and is not part of the calculation.
Step 1: Double every other digit from the right
Starting with the rightmost digit of the first nine digits, double every other value. If doubling creates a two-digit number, add those digits together.
Step 2: Add all digits plus the NPI constant
Add the transformed values, the unchanged digits, and the constant 24.
Step 3: Find the amount needed to reach the next multiple of 10
The next multiple of ten after 61 is 70. The difference is the calculated check digit.
Other Providers at the Same Location
The following 1 provider is registered at the same or a nearby location.
PRESCOTT VALLEY, AZ 86315
Frequently Asked Questions
The NPI number assigned to this healthcare provider is 1356358519, enumerated as an "organization" on August 01, 2006.
The provider is located at 15801 E DON CARLOS DR PRESCOTT VALLEY, AZ 86315 and the phone number is (602) 335-2068.
Residential Treatment Facility, Emotionally Disturbed Children with taxonomy code 322D00000X.
The provider might be accepting Accepts: Ambetter from Arizona Complete Health, Ambetter. Please consult your insurance carrier or call the provider to verify.
