Organization
MINGUS MOUNTAIN ESTATE RESIDENTIAL CENTER INC
Active
Organization
MINGUS MOUNTAIN ESTATE RESIDENTIAL CENTER INC
Active
Other names
Emily House
Organization subpart
No
Provider details
NPI number
Authorized official
BROOKE WILSON (SENIOR CREDENTIALING SPECIALIST)
(602) 335-2000
Entity
Organization
Contact information
Practice address
3801 N ROBERT RD, PRESCOTT VALLEY, AZ 86314-8107
(602) 335-2095
(602) 249-1311
Mailing address
2517 N GREAT WESTERN DR, PRESCOTT VALLEY, AZ 86314-2597
(602) 335-2000
(480) 534-7494
Taxonomy
Speciality
Code
Description
License number
State
3104A0630X
Assisted Living Facility (Behavioral Disturbances)
Primary
BH-1487
AZ
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
498057
—
AZ
Enumeration date
11/16/2006
Last updated
03/10/2025
Update your record
If you believe information in your NPPES record is inaccurate, or if you wish to update or deactivate your NPI, you can do so directly with CMS at https://nppes.cms.hhs.gov.
About Stedi
Stedi is the only programmable healthcare clearinghouse. You can use Stedi's APIs to process eligibility checks, claims, remits, and more.
Sign up