MINGUS MOUNTAIN ESTATE RESIDENCIAL CENTER, INC.
NPI 1467654814
Assisted Living Facility - Assisted Living, Behavioral Disturbances in Prescott Valley, AZ

Q: What is Mingus Mountain Estate Residencial Center, Inc.'s specialty?

The primary specialty registered for this NPI is Assisted Living Facility, specializing in Assisted Living, Behavioral Disturbances, with taxonomy code 3104A0630X.

Active since June 05, 2007

HC 76 HWY 89 A N JUNCTION 151, PRESCOTT VALLEY, AZ 86312(602) 335-2000 Get Directions Write a Review

NPPES record last updated: September 11, 2025. Verified against the NPPES registry weekly; last sync: August 23, 2026.

Record update history: Sep 11, 2025, Aug 22, 2020 (2 updates tracked since 2020).

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About Mingus Mountain Estate Residencial Center, Inc. NPPES

Official registry information on file with the National Plan and Provider Enumeration System.

MINGUS MOUNTAIN ESTATE RESIDENCIAL CENTER, INC. (NPI 1467654814) is a healthcare organization registered as an assisted living, behavioral disturbances in Prescott Valley, Arizona and active in the NPI registry since June 2007. The organization lists Chris Banken, Executive Director, as its authorized official.

NPPES Registry Identity

NPI1467654814

Entity TypeOrganization

Primary Taxonomy3104A0630X

Legal Business NameMINGUS MOUNTAIN ESTATE RESIDENCIAL CENTER, INC.

Location AddressHC 76 HWY 89 A N JUNCTION 151Prescott Valley, AZ 86312-6485

Mailing AddressPo Box 26485Prescott Valley, AZ 86312-6485 · (602) 335-2000 · Fax (602) 249-1311

Phone(602) 335-2000

Organization SubpartNo

Authorized OfficialChris BankenExecutive Director · (602) 335-2000

Enumeration DateJune 5, 2007

Last NPPES UpdateSeptember 11, 20252 updates tracked since enumeration

✔ NPI 1467654814 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses 2

★ Primary SpecialtyAssisted Living Facility · Assisted Living, Behavioral DisturbancesNursing & Custodial Care Facilities

Taxonomy Code3104A0630X

License✔ Licensed in AZ · BH-1487

Definition

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.

Also ListedResidential Treatment Facility, Emotionally Disturbed ChildrenTaxonomy 322D00000X · License BH-312 (AZ)

HC 76 HWY 89 A N JUNCTION 151, Prescott Valley, AZ 86312

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Other Identifiers 3

Medicaid590118AZ

Medicaid497744AZ

Medicaid498057AZ

Frequently Asked Questions NPPES & CMS

Common questions about this NPI record, answered from the official NPPES registry and CMS datasets shown on this page.

What is Mingus Mountain Estate Residencial Center, Inc.'s NPI number?

The NPI number for Mingus Mountain Estate Residencial Center, Inc. is 1467654814. It was assigned to this organization in the NPPES registry on June 5, 2007.

Where is Mingus Mountain Estate Residencial Center, Inc. located?

Mingus Mountain Estate Residencial Center, Inc. is located at Hc 76 Hwy 89 A N Junction 151, Prescott Valley, AZ 86312. The listed phone number is (602) 335-2000.

What is Mingus Mountain Estate Residencial Center, Inc.'s specialty?

The primary specialty registered for this NPI is Assisted Living Facility, specializing in Assisted Living, Behavioral Disturbances, with taxonomy code 3104A0630X.

When was this NPI record last updated?

The NPPES record for Mingus Mountain Estate Residencial Center, Inc. was last updated on September 11, 2025. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 11 months ago. If this record has changed at CMS more recently, you can request an on-demand re-check against the live CMS registry, directly from this page.