Organization
MINGUS MOUNTAIN ESTATE RESIDENTIAL CENTER INC.
Active
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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