Organization
MINGUS MOUNTAIN ESTATE RESIDENTIAL CENTER INC.
Active
Other names
Mingus Mountain Academy
Organization subpart
No
Provider details
NPI number
Authorized official
MR. CHRIS BANKEN (EXECUTIVE DIRECTOR)
(602) 335-2000
Entity
Organization
Contact information
Practice address
8349 EAST SPOUSE DRIVE, SUITE B, PRESCOTT VALLEY, AZ 86314
(602) 335-3000
Mailing address
PO BOX 26485, PRESCOTT VALLEY, AZ 86312-6485
(602) 335-2000
Taxonomy
Speciality
Code
Description
License number
State
101YM0800X
Mental Health Counselor
BH-2839
AZ
251S00000X
Community/Behavioral Health Agency
Primary
BH 2839
AZ
Other
Enumeration date
01/30/2007
Last updated
09/11/2025
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