Type 2 · Organization ✓ Active NPI ✓ Valid NPI checksum

Mingus Mountain Estate Residential Center Inc

Assisted Living Facility (Behavioral Disturbances) in Prescott Valley, AZ · enumerated 2006 · authorized official Brooke Wilson, Senior Credentialing Specialist.

Data current as of Jul 13, 2026 · sourced from CMS NPPES

National Provider Identifier

1497828503

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Registry record

Entity type Organization (Type 2)

Legal business name Mingus Mountain Estate Residential Center Inc

Other name <Unavail>

Practice address 3801 N Robert Rd, Prescott Valley, AZ, 86314

Phone (602) 335-2095

Fax (602) 249-1311

Enumeration date Nov 16, 2006

Last updated in NPPES Mar 10, 2025

Taxonomy & classification

3104A0630X Assisted Living Facility (Behavioral Disturbances) Nursing & Custodial Care Facilities · License BH-1487 (AZ) Primary

Authorized official

Name Brooke Wilson

Title Senior Credentialing Specialist

Phone (602) 335-2000

Other identifiers

Identifier	Type	State	Issuer
498057	Medicaid	AZ	-

What is an NPI number?

A National Provider Identifier (NPI) is a unique 10-digit number that CMS assigns to every U.S. healthcare provider and organization under HIPAA. Type 1 NPIs identify individual providers; Type 2 NPIs identify organizations. The NPI appears on insurance claims, prescriptions, and credentialing paperwork, and never changes, even if the provider moves or changes specialty.

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Frequently asked questions

How current is this record?

Data comes from the CMS NPPES public dissemination file; this record was last updated in NPPES on 2025-03-10. Verify at npiregistry.cms.hhs.gov.

Where is Mingus Mountain Estate Residential Center Inc located?

The practice location on file with NPPES is in Prescott Valley, AZ.

Source: CMS NPPES (public data). Snapshot 2026-07-13. Provider record last updated 2025-03-10.