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 2 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
- Clear Silver - 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
- Complete Silver - EPO
- Complete Silver + 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
- Elite Bronze - PPO
- Elite Bronze + Vision + Adult Dental - PPO
- Elite Gold - PPO
- Elite Gold + 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
- Blue AdvanceHealth Bronze - Neighborhood Network - HMO
- Blue AdvanceHealth Gold - Neighborhood Network - HMO
- Blue AdvanceHealth Silver - Neighborhood Network - HMO
- Blue EverydayHealth Gold - Neighborhood Network - HMO
- Blue EverydayHealth Silver - Neighborhood Network - HMO
- Blue Portfolio HSA Bronze - Neighborhood Network - HMO
- Blue Portfolio HSA Gold - Statewide PPO Network - PPO
- Blue PPO PremierHealth Silver - Statewide PPO Network - PPO
- Blue PPO PremierHealth Gold - Statewide PPO Network - PPO
- Blue PPO StandardHealth Gold - Statewide PPO Network - PPO
- Blue PPO StandardHealth Silver - Statewide PPO Network - PPO
- Blue StandardHealth Bronze - Neighborhood Network - HMO
- Blue StandardHealth Gold - Neighborhood Network - HMO
- Blue StandardHealth Silver - Neighborhood Network - 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.
Reviews for MINGUS MOUNTAIN ESTATE RESIDENTIAL CENTER INC
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NPI Validation Check Digit Calculation
The following table explains the step by step NPI number validation process using the ISO standard Luhn algorithm.
| Start with the original NPI number, the last digit is the check digit and is not used in the calculation. | |||||||||
| 1 | 3 | 5 | 6 | 3 | 5 | 8 | 5 | 1 | 9 |
| Step 1: Double the value of the alternate digits, beginning with the rightmost digit. | |||||||||
| 2 | 3 | 10 | 6 | 6 | 5 | 16 | 5 | 2 | |
| Step 2: Add all the doubled and unaffected individual digits from step 1 plus the constant number 24. | |||||||||
| 2 + 3 + 1 + 0 + 6 + 6 + 5 + 1 + 6 + 5 + 2 + 24 = 61 | |||||||||
| Step 3: Subtract the total obtained in step 2 from the next higher number ending in zero, the result is the check digit. | |||||||||
| 70 - 61 = 9 | 9 | ||||||||
The NPI number 1356358519 is valid because the calculated check digit 9 using the Luhn validation algorithm matches the last digit of the original NPI number.
Other Providers at the Same Location
The following provider is registered at the same or nearby location.
| NPI | Name / Type | Taxonomy | Address |
|---|---|---|---|
| 1851381388 | GAYLE L GREGORY MD Individual | Psychiatry & Neurology (Child & Adolescent Psychiatry) | 15801 E DON CARLOS DR PRESCOTT VALLEY, AZ 86315 (602) 335-2000 |
Frequently Asked Questions
The NPI number assigned to this healthcare provider is 1356358519, enumerated in the NPI registry 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
This medical organization specializes in 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 make sure your health plan is currently accepted.
The provider's CLIA number is 03D1096519 for a "other" facility with a CLIA Certificate of Waiver. This CLIA certificate is issued 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..
This NPI record was last updated on August 01, 2006. To officially update your NPI information contact the National Plan and Provider Enumeration System (NPPES) at 1-800-465-3203 (NPI Toll-Free) or by email at [email protected].
NPI Profile data is regularly updated with the latest NPI registry information, if you would like to update or remove your NPI Profile in this website please contact us.